research questions on healthcare

77 interesting medical research topics for 2024

Last updated

25 November 2023

Reviewed by

Brittany Ferri, PhD, OTR/L

Medical research is the gateway to improved patient care and expanding our available treatment options. However, finding a relevant and compelling research topic can be challenging.

Use this article as a jumping-off point to select an interesting medical research topic for your next paper or clinical study.

• How to choose a medical research topic

When choosing a research topic , it’s essential to consider a couple of things. What topics interest you? What unanswered questions do you want to address? 

During the decision-making and brainstorming process, here are a few helpful tips to help you pick the right medical research topic:

Focus on a particular field of study

The best medical research is specific to a particular area. Generalized studies are often too broad to produce meaningful results, so we advise picking a specific niche early in the process. 

Maybe a certain topic interests you, or your industry knowledge reveals areas of need.

Look into commonly researched topics

Once you’ve chosen your research field, do some preliminary research. What have other academics done in their papers and projects? 

From this list, you can focus on specific topics that interest you without accidentally creating a copycat project. This groundwork will also help you uncover any literature gaps—those may be beneficial areas for research.

Get curious and ask questions

Now you can get curious. Ask questions that start with why, how, or what. These questions are the starting point of your project design and will act as your guiding light throughout the process. 

For example: 

What impact does pollution have on children’s lung function in inner-city neighborhoods? 

Why is pollution-based asthma on the rise? 

How can we address pollution-induced asthma in young children? 

• 77 medical research topics worth exploring in 2023

Need some research inspiration for your upcoming paper or clinical study? We’ve compiled a list of 77 topical and in-demand medical research ideas. Let’s take a look. 

• Exciting new medical research topics

If you want to study cutting-edge topics, here are some exciting options:

COVID-19 and long COVID symptoms

Since 2020, COVID-19 has been a hot-button topic in medicine, along with the long-term symptoms in those with a history of COVID-19. 

Examples of COVID-19-related research topics worth exploring include:

The long-term impact of COVID-19 on cardiac and respiratory health

COVID-19 vaccination rates

The evolution of COVID-19 symptoms over time

New variants and strains of the COVID-19 virus

Changes in social behavior and public health regulations amid COVID-19

Vaccinations

Finding ways to cure or reduce the disease burden of chronic infectious diseases is a crucial research area. Vaccination is a powerful option and a great topic to research. 

Examples of vaccination-related research topics include:

mRNA vaccines for viral infections

Biomaterial vaccination capabilities

Vaccination rates based on location, ethnicity, or age

Public opinion about vaccination safety 

Artificial tissues fabrication

With the need for donor organs increasing, finding ways to fabricate artificial bioactive tissues (and possibly organs) is a popular research area. 

Examples of artificial tissue-related research topics you can study include:

The viability of artificially printed tissues

Tissue substrate and building block material studies

The ethics and efficacy of artificial tissue creation

• Medical research topics for medical students

For many medical students, research is a big driver for entering healthcare. If you’re a medical student looking for a research topic, here are some great ideas to work from:

Sleep disorders

Poor sleep quality is a growing problem, and it can significantly impact a person’s overall health. 

Examples of sleep disorder-related research topics include:

How stress affects sleep quality

The prevalence and impact of insomnia on patients with mental health conditions

Possible triggers for sleep disorder development

The impact of poor sleep quality on psychological and physical health

How melatonin supplements impact sleep quality

Alzheimer’s and dementia 

Cognitive conditions like dementia and Alzheimer’s disease are on the rise worldwide. They currently have no cure. As a result, research about these topics is in high demand. 

Examples of dementia-related research topics you could explore include:

The prevalence of Alzheimer’s disease in a chosen population

Early onset symptoms of dementia

Possible triggers or causes of cognitive decline with age

Treatment options for dementia-like conditions

The mental and physical burden of caregiving for patients with dementia

• Lifestyle habits and public health

Modern lifestyles have profoundly impacted the average person’s daily habits, and plenty of interesting topics explore its effects. 

Examples of lifestyle and public health-related research topics include:

The nutritional intake of college students

The impact of chronic work stress on overall health

The rise of upper back and neck pain from laptop use

Prevalence and cause of repetitive strain injuries (RSI)

• Controversial medical research paper topics

Medical research is a hotbed of controversial topics, content, and areas of study. 

If you want to explore a more niche (and attention-grabbing) concept, here are some controversial medical research topics worth looking into:

The benefits and risks of medical cannabis

Depending on where you live, the legalization and use of cannabis for medical conditions is controversial for the general public and healthcare providers.

Examples of medical cannabis-related research topics that might grab your attention include:

The legalization process of medical cannabis

The impact of cannabis use on developmental milestones in youth users

Cannabis and mental health diagnoses

CBD’s impact on chronic pain

Prevalence of cannabis use in young people

The impact of maternal cannabis use on fetal development 

Understanding how THC impacts cognitive function

Human genetics

The Human Genome Project identified, mapped, and sequenced all human DNA genes. Its completion in 2003 opened up a world of exciting and controversial studies in human genetics.

Examples of human genetics-related research topics worth delving into include:

Medical genetics and the incidence of genetic-based health disorders

Behavioral genetics differences between identical twins

Genetic risk factors for neurodegenerative disorders

Machine learning technologies for genetic research

Sexual health studies

Human sexuality and sexual health are important (yet often stigmatized) medical topics that need new research and analysis.

As a diverse field ranging from sexual orientation studies to sexual pathophysiology, examples of sexual health-related research topics include:

The incidence of sexually transmitted infections within a chosen population

Mental health conditions within the LGBTQIA+ community

The impact of untreated sexually transmitted infections

Access to safe sex resources (condoms, dental dams, etc.) in rural areas

• Health and wellness research topics

Human wellness and health are trendy topics in modern medicine as more people are interested in finding natural ways to live healthier lifestyles. 

If this field of study interests you, here are some big topics in the wellness space:

Gluten sensitivity

Gluten allergies and intolerances have risen over the past few decades. If you’re interested in exploring this topic, your options range in severity from mild gastrointestinal symptoms to full-blown anaphylaxis. 

Some examples of gluten sensitivity-related research topics include:

The pathophysiology and incidence of Celiac disease

Early onset symptoms of gluten intolerance

The prevalence of gluten allergies within a set population

Gluten allergies and the incidence of other gastrointestinal health conditions

Pollution and lung health

Living in large urban cities means regular exposure to high levels of pollutants. 

As more people become interested in protecting their lung health, examples of impactful lung health and pollution-related research topics include:

The extent of pollution in densely packed urban areas

The prevalence of pollution-based asthma in a set population

Lung capacity and function in young people

The benefits and risks of steroid therapy for asthma

Pollution risks based on geographical location

Plant-based diets

Plant-based diets like vegan and paleo diets are emerging trends in healthcare due to their limited supporting research. 

If you’re interested in learning more about the potential benefits or risks of holistic, diet-based medicine, examples of plant-based diet research topics to explore include:

Vegan and plant-based diets as part of disease management

Potential risks and benefits of specific plant-based diets

Plant-based diets and their impact on body mass index

The effect of diet and lifestyle on chronic disease management

Health supplements

Supplements are a multi-billion dollar industry. Many health-conscious people take supplements, including vitamins, minerals, herbal medicine, and more. 

Examples of health supplement-related research topics worth investigating include:

Omega-3 fish oil safety and efficacy for cardiac patients

The benefits and risks of regular vitamin D supplementation

Health supplementation regulation and product quality

The impact of social influencer marketing on consumer supplement practices

Analyzing added ingredients in protein powders

• Healthcare research topics

Working within the healthcare industry means you have insider knowledge and opportunity. Maybe you’d like to research the overall system, administration, and inherent biases that disrupt access to quality care. 

While these topics are essential to explore, it is important to note that these studies usually require approval and oversight from an Institutional Review Board (IRB). This ensures the study is ethical and does not harm any subjects. 

For this reason, the IRB sets protocols that require additional planning, so consider this when mapping out your study’s timeline. 

Here are some examples of trending healthcare research areas worth pursuing:

The pros and cons of electronic health records

The rise of electronic healthcare charting and records has forever changed how medical professionals and patients interact with their health data. 

Examples of electronic health record-related research topics include:

The number of medication errors reported during a software switch

Nurse sentiment analysis of electronic charting practices

Ethical and legal studies into encrypting and storing personal health data

Inequities within healthcare access

Many barriers inhibit people from accessing the quality medical care they need. These issues result in health disparities and injustices. 

Examples of research topics about health inequities include:

The impact of social determinants of health in a set population

Early and late-stage cancer stage diagnosis in urban vs. rural populations

Affordability of life-saving medications

Health insurance limitations and their impact on overall health

Diagnostic and treatment rates across ethnicities

People who belong to an ethnic minority are more likely to experience barriers and restrictions when trying to receive quality medical care. This is due to systemic healthcare racism and bias. 

As a result, diagnostic and treatment rates in minority populations are a hot-button field of research. Examples of ethnicity-based research topics include:

Cancer biopsy rates in BIPOC women

The prevalence of diabetes in Indigenous communities

Access inequalities in women’s health preventative screenings

The prevalence of undiagnosed hypertension in Black populations

• Pharmaceutical research topics

Large pharmaceutical companies are incredibly interested in investing in research to learn more about potential cures and treatments for diseases. 

If you’re interested in building a career in pharmaceutical research, here are a few examples of in-demand research topics:

Cancer treatment options

Clinical research is in high demand as pharmaceutical companies explore novel cancer treatment options outside of chemotherapy and radiation. 

Examples of cancer treatment-related research topics include:

Stem cell therapy for cancer

Oncogenic gene dysregulation and its impact on disease

Cancer-causing viral agents and their risks

Treatment efficacy based on early vs. late-stage cancer diagnosis

Cancer vaccines and targeted therapies

Immunotherapy for cancer

Pain medication alternatives

Historically, opioid medications were the primary treatment for short- and long-term pain. But, with the opioid epidemic getting worse, the need for alternative pain medications has never been more urgent. 

Examples of pain medication-related research topics include:

Opioid withdrawal symptoms and risks

Early signs of pain medication misuse

Anti-inflammatory medications for pain control

• Identify trends in your medical research with Dovetail

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Research Topics & Ideas: Healthcare

100+ Healthcare Research Topic Ideas To Fast-Track Your Project

Finding and choosing a strong research topic is the critical first step when it comes to crafting a high-quality dissertation, thesis or research project. If you’ve landed on this post, chances are you’re looking for a healthcare-related research topic , but aren’t sure where to start. Here, we’ll explore a variety of healthcare-related research ideas and topic thought-starters across a range of healthcare fields, including allopathic and alternative medicine, dentistry, physical therapy, optometry, pharmacology and public health.

NB – This is just the start…

The topic ideation and evaluation process has multiple steps . In this post, we’ll kickstart the process by sharing some research topic ideas within the healthcare domain. This is the starting point, but to develop a well-defined research topic, you’ll need to identify a clear and convincing research gap , along with a well-justified plan of action to fill that gap.

If you’re new to the oftentimes perplexing world of research, or if this is your first time undertaking a formal academic research project, be sure to check out our free dissertation mini-course. In it, we cover the process of writing a dissertation or thesis from start to end. Be sure to also sign up for our free webinar that explores how to find a high-quality research topic.

Overview: Healthcare Research Topics

• Allopathic medicine
• Alternative /complementary medicine
• Veterinary medicine
• Physical therapy/ rehab
• Optometry and ophthalmology
• Pharmacy and pharmacology
• Public health
• Examples of healthcare-related dissertations

Allopathic (Conventional) Medicine

• The effectiveness of telemedicine in remote elderly patient care
• The impact of stress on the immune system of cancer patients
• The effects of a plant-based diet on chronic diseases such as diabetes
• The use of AI in early cancer diagnosis and treatment
• The role of the gut microbiome in mental health conditions such as depression and anxiety
• The efficacy of mindfulness meditation in reducing chronic pain: A systematic review
• The benefits and drawbacks of electronic health records in a developing country
• The effects of environmental pollution on breast milk quality
• The use of personalized medicine in treating genetic disorders
• The impact of social determinants of health on chronic diseases in Asia
• The role of high-intensity interval training in improving cardiovascular health
• The efficacy of using probiotics for gut health in pregnant women
• The impact of poor sleep on the treatment of chronic illnesses
• The role of inflammation in the development of chronic diseases such as lupus
• The effectiveness of physiotherapy in pain control post-surgery

Topics & Ideas: Alternative Medicine

• The benefits of herbal medicine in treating young asthma patients
• The use of acupuncture in treating infertility in women over 40 years of age
• The effectiveness of homoeopathy in treating mental health disorders: A systematic review
• The role of aromatherapy in reducing stress and anxiety post-surgery
• The impact of mindfulness meditation on reducing high blood pressure
• The use of chiropractic therapy in treating back pain of pregnant women
• The efficacy of traditional Chinese medicine such as Shun-Qi-Tong-Xie (SQTX) in treating digestive disorders in China
• The impact of yoga on physical and mental health in adolescents
• The benefits of hydrotherapy in treating musculoskeletal disorders such as tendinitis
• The role of Reiki in promoting healing and relaxation post birth
• The effectiveness of naturopathy in treating skin conditions such as eczema
• The use of deep tissue massage therapy in reducing chronic pain in amputees
• The impact of tai chi on the treatment of anxiety and depression
• The benefits of reflexology in treating stress, anxiety and chronic fatigue
• The role of acupuncture in the prophylactic management of headaches and migraines

Topics & Ideas: Dentistry

• The impact of sugar consumption on the oral health of infants
• The use of digital dentistry in improving patient care: A systematic review
• The efficacy of orthodontic treatments in correcting bite problems in adults
• The role of dental hygiene in preventing gum disease in patients with dental bridges
• The impact of smoking on oral health and tobacco cessation support from UK dentists
• The benefits of dental implants in restoring missing teeth in adolescents
• The use of lasers in dental procedures such as root canals
• The efficacy of root canal treatment using high-frequency electric pulses in saving infected teeth
• The role of fluoride in promoting remineralization and slowing down demineralization
• The impact of stress-induced reflux on oral health
• The benefits of dental crowns in restoring damaged teeth in elderly patients
• The use of sedation dentistry in managing dental anxiety in children
• The efficacy of teeth whitening treatments in improving dental aesthetics in patients with braces
• The role of orthodontic appliances in improving well-being
• The impact of periodontal disease on overall health and chronic illnesses

Tops & Ideas: Veterinary Medicine

• The impact of nutrition on broiler chicken production
• The role of vaccines in disease prevention in horses
• The importance of parasite control in animal health in piggeries
• The impact of animal behaviour on welfare in the dairy industry
• The effects of environmental pollution on the health of cattle
• The role of veterinary technology such as MRI in animal care
• The importance of pain management in post-surgery health outcomes
• The impact of genetics on animal health and disease in layer chickens
• The effectiveness of alternative therapies in veterinary medicine: A systematic review
• The role of veterinary medicine in public health: A case study of the COVID-19 pandemic
• The impact of climate change on animal health and infectious diseases in animals
• The importance of animal welfare in veterinary medicine and sustainable agriculture
• The effects of the human-animal bond on canine health
• The role of veterinary medicine in conservation efforts: A case study of Rhinoceros poaching in Africa
• The impact of veterinary research of new vaccines on animal health

Topics & Ideas: Physical Therapy/Rehab

• The efficacy of aquatic therapy in improving joint mobility and strength in polio patients
• The impact of telerehabilitation on patient outcomes in Germany
• The effect of kinesiotaping on reducing knee pain and improving function in individuals with chronic pain
• A comparison of manual therapy and yoga exercise therapy in the management of low back pain
• The use of wearable technology in physical rehabilitation and the impact on patient adherence to a rehabilitation plan
• The impact of mindfulness-based interventions in physical therapy in adolescents
• The effects of resistance training on individuals with Parkinson’s disease
• The role of hydrotherapy in the management of fibromyalgia
• The impact of cognitive-behavioural therapy in physical rehabilitation for individuals with chronic pain
• The use of virtual reality in physical rehabilitation of sports injuries
• The effects of electrical stimulation on muscle function and strength in athletes
• The role of physical therapy in the management of stroke recovery: A systematic review
• The impact of pilates on mental health in individuals with depression
• The use of thermal modalities in physical therapy and its effectiveness in reducing pain and inflammation
• The effect of strength training on balance and gait in elderly patients

Topics & Ideas: Optometry & Opthalmology

• The impact of screen time on the vision and ocular health of children under the age of 5
• The effects of blue light exposure from digital devices on ocular health
• The role of dietary interventions, such as the intake of whole grains, in the management of age-related macular degeneration
• The use of telemedicine in optometry and ophthalmology in the UK
• The impact of myopia control interventions on African American children’s vision
• The use of contact lenses in the management of dry eye syndrome: different treatment options
• The effects of visual rehabilitation in individuals with traumatic brain injury
• The role of low vision rehabilitation in individuals with age-related vision loss: challenges and solutions
• The impact of environmental air pollution on ocular health
• The effectiveness of orthokeratology in myopia control compared to contact lenses
• The role of dietary supplements, such as omega-3 fatty acids, in ocular health
• The effects of ultraviolet radiation exposure from tanning beds on ocular health
• The impact of computer vision syndrome on long-term visual function
• The use of novel diagnostic tools in optometry and ophthalmology in developing countries
• The effects of virtual reality on visual perception and ocular health: an examination of dry eye syndrome and neurologic symptoms

Topics & Ideas: Pharmacy & Pharmacology

• The impact of medication adherence on patient outcomes in cystic fibrosis
• The use of personalized medicine in the management of chronic diseases such as Alzheimer’s disease
• The effects of pharmacogenomics on drug response and toxicity in cancer patients
• The role of pharmacists in the management of chronic pain in primary care
• The impact of drug-drug interactions on patient mental health outcomes
• The use of telepharmacy in healthcare: Present status and future potential
• The effects of herbal and dietary supplements on drug efficacy and toxicity
• The role of pharmacists in the management of type 1 diabetes
• The impact of medication errors on patient outcomes and satisfaction
• The use of technology in medication management in the USA
• The effects of smoking on drug metabolism and pharmacokinetics: A case study of clozapine
• Leveraging the role of pharmacists in preventing and managing opioid use disorder
• The impact of the opioid epidemic on public health in a developing country
• The use of biosimilars in the management of the skin condition psoriasis
• The effects of the Affordable Care Act on medication utilization and patient outcomes in African Americans

Topics & Ideas: Public Health

• The impact of the built environment and urbanisation on physical activity and obesity
• The effects of food insecurity on health outcomes in Zimbabwe
• The role of community-based participatory research in addressing health disparities
• The impact of social determinants of health, such as racism, on population health
• The effects of heat waves on public health
• The role of telehealth in addressing healthcare access and equity in South America
• The impact of gun violence on public health in South Africa
• The effects of chlorofluorocarbons air pollution on respiratory health
• The role of public health interventions in reducing health disparities in the USA
• The impact of the United States Affordable Care Act on access to healthcare and health outcomes
• The effects of water insecurity on health outcomes in the Middle East
• The role of community health workers in addressing healthcare access and equity in low-income countries
• The impact of mass incarceration on public health and behavioural health of a community
• The effects of floods on public health and healthcare systems
• The role of social media in public health communication and behaviour change in adolescents

Examples: Healthcare Dissertation & Theses

While the ideas we’ve presented above are a decent starting point for finding a healthcare-related research topic, they are fairly generic and non-specific. So, it helps to look at actual dissertations and theses to see how this all comes together.

Below, we’ve included a selection of research projects from various healthcare-related degree programs to help refine your thinking. These are actual dissertations and theses, written as part of Master’s and PhD-level programs, so they can provide some useful insight as to what a research topic looks like in practice.

• Improving Follow-Up Care for Homeless Populations in North County San Diego (Sanchez, 2021)
• On the Incentives of Medicare’s Hospital Reimbursement and an Examination of Exchangeability (Elzinga, 2016)
• Managing the healthcare crisis: the career narratives of nurses (Krueger, 2021)
• Methods for preventing central line-associated bloodstream infection in pediatric haematology-oncology patients: A systematic literature review (Balkan, 2020)
• Farms in Healthcare: Enhancing Knowledge, Sharing, and Collaboration (Garramone, 2019)
• When machine learning meets healthcare: towards knowledge incorporation in multimodal healthcare analytics (Yuan, 2020)
• Integrated behavioural healthcare: The future of rural mental health (Fox, 2019)
• Healthcare service use patterns among autistic adults: A systematic review with narrative synthesis (Gilmore, 2021)
• Mindfulness-Based Interventions: Combatting Burnout and Compassionate Fatigue among Mental Health Caregivers (Lundquist, 2022)
• Transgender and gender-diverse people’s perceptions of gender-inclusive healthcare access and associated hope for the future (Wille, 2021)
• Efficient Neural Network Synthesis and Its Application in Smart Healthcare (Hassantabar, 2022)
• The Experience of Female Veterans and Health-Seeking Behaviors (Switzer, 2022)
• Machine learning applications towards risk prediction and cost forecasting in healthcare (Singh, 2022)
• Does Variation in the Nursing Home Inspection Process Explain Disparity in Regulatory Outcomes? (Fox, 2020)

Looking at these titles, you can probably pick up that the research topics here are quite specific and narrowly-focused , compared to the generic ones presented earlier. This is an important thing to keep in mind as you develop your own research topic. That is to say, to create a top-notch research topic, you must be precise and target a specific context with specific variables of interest . In other words, you need to identify a clear, well-justified research gap.

Need more help?

If you’re still feeling a bit unsure about how to find a research topic for your healthcare dissertation or thesis, check out Topic Kickstarter service below.

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15 Comments

I need topics that will match the Msc program am running in healthcare research please

Hello Mabel,

I can help you with a good topic, kindly provide your email let’s have a good discussion on this.

Can you provide some research topics and ideas on Immunology?

Thank you to create new knowledge on research problem verse research topic

Help on problem statement on teen pregnancy

This post might be useful: https://gradcoach.com/research-problem-statement/

can you provide me with a research topic on healthcare related topics to a qqi level 5 student

Please can someone help me with research topics in public health ?

Hello I have requirement of Health related latest research issue/topics for my social media speeches. If possible pls share health issues , diagnosis, treatment.

I would like a topic thought around first-line support for Gender-Based Violence for survivors or one related to prevention of Gender-Based Violence

Please can I be helped with a master’s research topic in either chemical pathology or hematology or immunology? thanks

Can u please provide me with a research topic on occupational health and safety at the health sector

Good day kindly help provide me with Ph.D. Public health topics on Reproductive and Maternal Health, interventional studies on Health Education

may you assist me with a good easy healthcare administration study topic

May you assist me in finding a research topic on nutrition,physical activity and obesity. On the impact on children

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Healthcare Research Paper Topics

In this page, we provide a comprehensive list of healthcare research paper topics , expert advice on selecting compelling topics, guidance on writing an impactful research paper, and information about iResearchNet’s writing services. By exploring these resources, students in the health sciences field can choose relevant and significant healthcare research paper topics, develop their papers effectively, and access professional writing assistance to excel in their academic endeavors.

100 Healthcare Research Paper Topics

The field of healthcare research encompasses a vast array of topics that are crucial for understanding, improving, and transforming healthcare practices. As students in the health sciences, you have the opportunity to explore these diverse areas and contribute to the knowledge base of healthcare research. This comprehensive list aims to inspire and guide you in selecting healthcare research paper topics that align with your interests and academic goals. The topics are divided into ten distinct categories, each containing ten thought-provoking and relevant research ideas. Let this list serve as a springboard for your exploration and a catalyst for impactful research in the dynamic field of healthcare.

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1. Healthcare Policy and Management

• The Impact of Health Policies on Access to Care
• Assessing the Effectiveness of Health Insurance Programs
• Analyzing the Role of Healthcare Leadership in Quality Improvement
• Exploring Strategies for Healthcare Cost Containment
• Investigating the Relationship Between Healthcare Regulations and Patient Outcomes
• Evaluating the Impact of Electronic Health Records on Healthcare Delivery
• Examining the Role of Public-Private Partnerships in Healthcare
• Analyzing the Influence of Political Factors on Healthcare Decision-Making
• Assessing the Ethical Implications of Resource Allocation in Healthcare
• Investigating the Effectiveness of Health Promotion Programs in Primary Care Settings

2. Healthcare Ethics and Legal Issues

• Analyzing the Ethical Challenges of Healthcare Research Involving Human Subjects
• Exploring the Impact of Cultural and Religious Beliefs on Healthcare Decision-Making
• Examining Legal Issues in End-of-Life Care and Advance Directives
• Investigating the Ethical Implications of Genetic Testing and Personalized Medicine
• Assessing the Ethical Dilemmas in Access to Experimental Treatments
• Exploring the Role of Ethics Committees in Healthcare Organizations
• Analyzing the Intersection of Healthcare Ethics and Artificial Intelligence
• Evaluating the Legal and Ethical Implications of Telemedicine
• Investigating the Ethics of Healthcare Resource Allocation during Public Health Emergencies
• Examining the Legal and Ethical Issues of Patient Privacy in the Digital Age

3. Healthcare Technology and Innovation

• Assessing the Impact of Artificial Intelligence in Healthcare Diagnostics
• Exploring the Potential of Wearable Devices for Remote Patient Monitoring
• Investigating the Role of Big Data Analytics in Healthcare Decision-Making
• Analyzing the Use of Robotics in Surgery and Patient Care
• Examining the Impact of Telehealth on Healthcare Access and Delivery
• Evaluating the Benefits and Challenges of Electronic Health Records Implementation
• Exploring the Applications of Virtual Reality in Healthcare Education and Training
• Investigating the Role of Mobile Health Applications in Health Behavior Change
• Assessing the Potential of Blockchain Technology in Healthcare Data Security
• Analyzing the Ethical and Social Implications of Genetic Engineering in Healthcare

4. Healthcare Quality and Patient Safety

• Evaluating the Impact of Patient-Centered Care on Health Outcomes
• Analyzing the Role of Quality Improvement Initiatives in Reducing Medical Errors
• Assessing the Effectiveness of Medication Safety Practices in Healthcare Settings
• Exploring Strategies to Improve Healthcare Communication and Interprofessional Collaboration
• Investigating the Relationship Between Nursing Workforce and Patient Safety
• Examining the Impact of Clinical Practice Guidelines on Healthcare Quality
• Analyzing the Role of Patient Engagement in Enhancing Healthcare Quality
• Evaluating the Effectiveness of Lean Six Sigma in Healthcare Process Improvement
• Exploring the Role of Health Information Technology in Enhancing Patient Safety
• Investigating the Influence of Organizational Culture on Healthcare Quality and Safety

5. Mental Health and Psychological Well-being

• Analyzing the Impact of Stigma on Mental Health Help-Seeking Behavior
• Exploring the Effectiveness of Psychotherapy Approaches in Treating Mental Health Disorders
• Assessing the Role of Early Intervention in Preventing Mental Health Disorders
• Investigating the Relationship Between Adverse Childhood Experiences and Mental Health Outcomes
• Examining the Intersection of Mental Health and Substance Abuse Disorders
• Evaluating the Impact of Mindfulness-Based Interventions on Psychological Well-being
• Exploring the Role of Social Support in Mental Health Recovery
• Analyzing the Effectiveness of Mental Health Awareness Campaigns
• Investigating the Influence of Cultural Factors on Mental Health Help-Seeking Behavior
• Examining the Mental Health Needs and Challenges among Specific Populations (e.g., LGBTQ+, Veterans, Refugees)

6. Chronic Diseases and their Management

• Assessing the Impact of Lifestyle Factors on Chronic Disease Prevention and Management
• Exploring the Role of Community-Based Interventions in Chronic Disease Control
• Investigating the Relationship Between Social Determinants of Health and Chronic Disease Burden
• Analyzing the Use of Digital Health Technologies in Chronic Disease Management
• Examining the Impact of Health Literacy on Chronic Disease Outcomes
• Evaluating the Effectiveness of Self-Management Programs for Chronic Conditions
• Exploring the Role of Healthcare Providers in Chronic Disease Prevention and Management
• Analyzing the Impact of Health Policies on Chronic Disease Prevention Efforts
• Investigating the Relationship Between Mental Health and Chronic Disease Management
• Examining the Disparities in Access to Chronic Disease Care and Treatment

7. Healthcare Disparities and Access to Care

• Analyzing Racial and Ethnic Disparities in Healthcare Access and Quality
• Exploring the Role of Socioeconomic Factors in Healthcare Disparities
• Assessing the Impact of Geographic Location on Healthcare Access and Health Outcomes
• Investigating Gender Disparities in Healthcare Utilization and Treatment
• Examining the Influence of Health Insurance Status on Healthcare Disparities
• Evaluating the Effectiveness of Culturally Competent Care in Reducing Disparities
• Exploring the Relationship Between Language Barriers and Healthcare Access
• Analyzing the Impact of Implicit Bias on Healthcare Disparities
• Investigating the Role of Health Literacy in Healthcare Disparities
• Examining the Disparities in Mental Health Services and Access to Mental Healthcare

8. Healthcare Education and Training

• Assessing the Effectiveness of Simulation-Based Training in Healthcare Education
• Exploring the Role of Interprofessional Education in Improving Collaborative Practice
• Investigating the Impact of Technology-Enhanced Learning in Healthcare Education
• Analyzing the Use of Gamification in Healthcare Training and Skill Development
• Examining the Role of Continuing Education in Enhancing Healthcare Providers’ Competence
• Evaluating the Effectiveness of Mentorship Programs in Healthcare Education
• Exploring Strategies to Address Cultural Competence in Healthcare Education
• Analyzing the Role of Reflective Practice in Healthcare Professional Development
• Investigating the Use of Team-Based Learning in Healthcare Education
• Examining the Impact of Experiential Learning in Healthcare Training Programs

9. Public Health and Preventive Medicine

• Assessing the Impact of Vaccination Programs on Public Health Outcomes
• Exploring the Role of Health Promotion Campaigns in Preventing Non-communicable Diseases
• Investigating the Effectiveness of Community-Based Interventions in Disease Prevention
• Analyzing the Impact of Environmental Factors on Public Health
• Examining the Role of Social Determinants of Health in Health Disparities
• Evaluating the Effectiveness of Public Health Policies in Tobacco Control
• Exploring Strategies for Preventing and Managing Infectious Diseases
• Analyzing the Role of Health Education in Promoting Healthy Lifestyles
• Investigating the Influence of Media on Public Health Perceptions and Behaviors
• Examining the Challenges and Opportunities in Global Health Initiatives

10. Emerging Topics in Healthcare Research

• Assessing the Implications of Artificial Intelligence in Healthcare
• Exploring the Role of Precision Medicine in Personalized Healthcare
• Investigating the Impact of Genomic Research on Healthcare Delivery
• Analyzing the Use of Telemedicine in Rural and Underserved Areas
• Examining the Integration of Traditional and Complementary Medicine in Healthcare
• Evaluating the Potential of Digital Therapeutics in Disease Management
• Exploring the Ethical Considerations of Gene Editing Technologies in Healthcare
• Analyzing the Influence of Social Media on Healthcare Decision-Making
• Investigating the Role of Health Information Exchange in Coordinated Care
• Examining the Implications of Health Equity in Healthcare Research and Practice

This comprehensive list of healthcare research paper topics encompasses a wide range of areas within the healthcare field. Each category offers diverse research ideas that can inspire students in the health sciences to explore pressing issues, propose innovative solutions, and contribute to the advancement of healthcare knowledge. Whether you are interested in healthcare policy, ethics, technology, mental health, chronic diseases, healthcare disparities, education, public health, or emerging healthcare research paper topics, this list serves as a valuable resource to kickstart your research journey. Choose a topic that resonates with you, aligns with your academic goals, and enables you to make a meaningful impact in the field of healthcare research. Remember, the pursuit of knowledge and the drive to improve healthcare practices are at the heart of your journey as a student in the health sciences.

Choosing Healthcare Research Paper Topics

Choosing the right healthcare research paper topic is a crucial step in conducting a successful and impactful study. With the vast array of healthcare issues and areas to explore, it can be challenging to narrow down your focus. To help you navigate this process effectively, we have compiled expert advice and ten essential tips for selecting compelling healthcare research paper topics. Consider these insights as you embark on your research journey in the dynamic field of healthcare:

• Follow Your Passion : Choose a topic that genuinely interests you. Passion and enthusiasm will drive your motivation, ensuring that you remain engaged throughout the research process.
• Stay Informed : Keep up with the latest healthcare trends, emerging issues, and ongoing debates. Stay informed through reputable sources, academic journals, conferences, and professional networks to identify current and relevant research gaps.
• Identify a Research Gap : Conduct a thorough literature review to identify areas where there is a need for further research. Look for unanswered questions, controversies, or gaps in knowledge that you can address in your study.
• Consider Relevance and Significance : Choose a topic that is relevant to current healthcare challenges or contributes to improving healthcare practices, policies, or patient outcomes. Aim for a topic that has real-world implications and societal impact.
• Delve into Specific Areas : Narrow down your focus by selecting a specific aspect or subtopic within the broad field of healthcare. This allows for a more focused and in-depth analysis of the chosen area.
• Consult with Your Advisor or Faculty : Seek guidance from your research advisor or faculty members who specialize in healthcare research. They can provide valuable insights, help you refine your topic, and direct you to relevant literature and resources.
• Brainstorm with Peers : Engage in discussions with your peers and classmates to explore different perspectives and gain inspiration. Collaborative brainstorming sessions can generate new ideas and offer fresh insights.
• Consider Ethical Considerations : Take ethical considerations into account when selecting a healthcare research topic. Ensure that your research adheres to ethical guidelines and respects the rights and privacy of participants, especially in studies involving human subjects.
• Think Interdisciplinary : Consider interdisciplinary approaches to healthcare research. Explore how other disciplines, such as sociology, psychology, economics, or technology, intersect with healthcare, providing a broader perspective and enhancing the depth of your research.
• Feasibility and Available Resources : Assess the feasibility of your chosen topic, considering the resources, time, and data availability required for your research. Ensure that you have access to relevant data sources, research tools, and necessary support to carry out your study effectively.

By following these expert tips, you will be equipped to choose a healthcare research paper topic that aligns with your interests, is relevant to current healthcare challenges, and has the potential to make a meaningful impact in the field. Remember, selecting the right topic sets the foundation for a successful research endeavor, allowing you to contribute to the advancement of healthcare knowledge and practices.

How to Write a Healthcare Research Paper

Writing a healthcare research paper requires careful planning, organization, and attention to detail. To help you navigate the intricacies of the writing process, we have compiled ten essential tips to guide you towards crafting a well-written and impactful healthcare research paper. Follow these expert recommendations to enhance the quality and effectiveness of your research paper:

• Develop a Clear Research Question : Start by formulating a clear and concise research question that will serve as the central focus of your paper. Ensure that your question is specific, measurable, achievable, relevant, and time-bound (SMART).
• Conduct a Thorough Literature Review : Before diving into your research, conduct a comprehensive literature review to familiarize yourself with existing knowledge on the topic. Identify key theories, concepts, methodologies, and gaps in the literature that your research aims to address.
• Create a Solid Research Design : Design a robust research plan that aligns with your research question. Define your study population, sampling strategy, data collection methods, and statistical analyses. A well-designed research plan enhances the validity and reliability of your findings.
• Collect and Analyze Data : Implement your data collection methods, ensuring ethical considerations and adherence to research protocols. Once collected, analyze the data using appropriate statistical techniques and tools. Provide a clear description of your analytical methods.
• Structure your Paper Effectively : Organize your research paper into logical sections, including an introduction, literature review, methodology, results, discussion, and conclusion. Use headings and subheadings to enhance readability and guide the reader through your paper.
• Write a Compelling Introduction : Start your paper with a strong introduction that captures the reader’s attention and provides a concise overview of the research topic, objectives, and significance. Clearly state your research question and the rationale for your study.
• Present Clear and Concise Results : Present your research findings in a clear and concise manner. Use tables, graphs, and figures where appropriate to enhance the readability of your results. Provide a comprehensive interpretation of the results, highlighting key findings and their implications.
• Engage in Critical Analysis and Discussion : Analyze and interpret your findings in the context of existing literature. Discuss the strengths and limitations of your study, addressing potential biases or confounders. Consider alternative explanations and provide a thoughtful discussion of the implications of your findings.
• Follow Proper Citation and Referencing Guidelines : Adhere to the appropriate citation style (such as APA, MLA, or Chicago) consistently throughout your paper. Cite all sources accurately and include a comprehensive list of references at the end of your paper.
• Revise and Edit : Before finalizing your research paper, revise and edit it thoroughly. Pay attention to clarity, coherence, grammar, spelling, and punctuation. Ensure that your arguments flow logically and that your paper is well-structured and cohesive.

By following these tips, you will be well-equipped to write a high-quality healthcare research paper that effectively communicates your findings, contributes to the existing knowledge in the field, and engages readers with your insights and conclusions. Remember to seek feedback from your peers, professors, or research advisors to further refine your paper and ensure its overall excellence.

iResearchNet’s Custom Writing Services

At iResearchNet, we understand the challenges students face when it comes to writing healthcare research papers. To support you in your academic journey and ensure the highest quality of your work, we offer a comprehensive range of writing services. With a team of expert degree-holding writers and a commitment to excellence, we are dedicated to providing customized solutions tailored to your specific needs. Here are the features that set our writing services apart:

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• Top Quality : We are committed to delivering research papers of the highest quality. Our writers follow strict quality control measures to ensure that your paper meets the academic standards, including proper structure, clarity of writing, and logical flow of ideas.
• Customized Solutions : We recognize that every research paper is unique. Our writers work closely with you to understand your research objectives, guidelines, and preferences. They tailor their approach to ensure that your research paper reflects your vision and academic goals.
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• Short Deadlines : We understand that time is often a critical factor. We offer short turnaround times, allowing you to meet tight deadlines without compromising the quality of your research paper. With our dedicated team, we can handle urgent requests efficiently.
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Nih research matters.

December 22, 2021

2021 Research Highlights — Promising Medical Findings

Results with potential for enhancing human health.

With NIH support, scientists across the United States and around the world conduct wide-ranging research to discover ways to enhance health, lengthen life, and reduce illness and disability. Groundbreaking NIH-funded research often receives top scientific honors. In 2021, these honors included Nobel Prizes to five NIH-supported scientists . Here’s just a small sample of the NIH-supported research accomplishments in 2021.

Printer-friendly version of full 2021 NIH Research Highlights

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Advancing COVID-19 treatment and prevention

Amid the sustained pandemic, researchers continued to develop new drugs and vaccines for COVID-19. They found oral drugs that could  inhibit virus replication in hamsters and shut down a key enzyme that the virus needs to replicate. Both drugs are currently in clinical trials. Another drug effectively treated both SARS-CoV-2 and RSV, another serious respiratory virus, in animals. Other researchers used an airway-on-a-chip to screen approved drugs for use against COVID-19. These studies identified oral drugs that could be administered outside of clinical settings. Such drugs could become powerful tools for fighting the ongoing pandemic. Also in development are an intranasal vaccine , which could help prevent virus transmission, and vaccines that can protect against a range of coronaviruses .

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Developments in Alzheimer’s disease research

One of the hallmarks of Alzheimer’s is an abnormal buildup of amyloid-beta protein. A study in mice suggests that antibody therapies targeting amyloid-beta protein could be more effective after enhancing the brain’s waste drainage system . In another study, irisin, an exercise-induced hormone, was found to improve cognitive performance in mice . New approaches also found two approved drugs (described below) with promise for treating AD. These findings point to potential strategies for treating Alzheimer’s. Meanwhile, researchers found that people who slept six hours or less per night in their 50s and 60s were more likely to develop dementia later in life, suggesting that inadequate sleep duration could increase dementia risk.

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New uses for old drugs

Developing new drugs can be costly, and the odds of success can be slim. So, some researchers have turned to repurposing drugs that are already approved for other conditions. Scientists found that two FDA-approved drugs were associated with lower rates of Alzheimer’s disease. One is used for high blood pressure and swelling. The other is FDA-approved to treat erectile dysfunction and pulmonary hypertension. Meanwhile, the antidepressant fluoxetine was associated with reduced risk of age-related macular degeneration. Clinical trials will be needed to confirm these drugs’ effects.

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Making a wireless, biodegradable pacemaker

Pacemakers are a vital part of medical care for many people with heart rhythm disorders. Temporary pacemakers currently use wires connected to a power source outside the body. Researchers developed a temporary pacemaker that is powered wirelessly. It also breaks down harmlessly in the body after use. Studies showed that the device can generate enough power to pace a human heart without causing damage or inflammation.

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Fungi may impair wound healing in Crohn’s disease

Inflammatory bowel disease develops when immune cells in the gut overreact to a perceived threat to the body. It’s thought that the microbiome plays a role in this process. Researchers found that a fungus called  Debaryomyces hansenii  impaired gut wound healing in mice and was also found in damaged gut tissue in people with Crohn’s disease, a type of inflammatory bowel disease. Blocking this microbe might encourage tissue repair in Crohn’s disease.

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Nanoparticle-based flu vaccine

Influenza, or flu, kills an estimated 290,000-650,000 people each year worldwide. The flu virus changes, or mutates, quickly. A single vaccine that conferred protection against a wide variety of strains would provide a major boost to global health. Researchers developed a nanoparticle-based vaccine that protected against a broad range of flu virus strains in animals. The vaccine may prevent flu more effectively than current seasonal vaccines. Researchers are planning a Phase 1 clinical trial to test the vaccine in people.

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A targeted antibiotic for treating Lyme disease

Lyme disease cases are becoming more frequent and widespread. Current treatment entails the use of broad-spectrum antibiotics. But these drugs can damage the patient’s gut microbiome and select for resistance in non-target bacteria. Researchers found that a neglected antibiotic called hygromycin A selectively kills the bacteria that cause Lyme disease. The antibiotic was able to treat Lyme disease in mice without disrupting the microbiome and could make an attractive therapeutic candidate.

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Retraining the brain to treat chronic pain

More than 25 million people in the U.S. live with chronic pain. After a treatment called pain reprocessing therapy, two-thirds of people with mild or moderate chronic back pain for which no physical cause could be found were mostly or completely pain-free. The findings suggest that people can learn to reduce the brain activity causing some types of chronic pain that occur in the absence of injury or persist after healing.

2021 Research Highlights — Basic Research Insights >>

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Examples of Research Questions

Phd in nursing science program, examples of broad clinical research questions include:.

• Does the administration of pain medication at time of surgical incision reduce the need for pain medication twenty-four hours after surgery?
• What maternal factors are associated with obesity in toddlers?
• What elements of a peer support intervention prevent suicide in high school females?
• What is the most accurate and comprehensive way to determine men’s experience of physical assault?
• Is yoga as effective as traditional physical therapy in reducing lymphedema in patients who have had head and neck cancer treatment?
• In the third stage of labor, what is the effect of cord cutting within the first three minutes on placenta separation?
• Do teenagers with Type 1 diabetes who receive phone tweet reminders maintain lower blood sugars than those who do not?
• Do the elderly diagnosed with dementia experience pain?
•  How can siblings’ risk of depression be predicted after the death of a child?
•  How can cachexia be prevented in cancer patients receiving aggressive protocols involving radiation and chemotherapy?

Examples of some general health services research questions are:

• Does the organization of renal transplant nurse coordinators’ responsibilities influence live donor rates?
• What activities of nurse managers are associated with nurse turnover?  30 day readmission rates?
• What effect does the Nurse Faculty Loan program have on the nurse researcher workforce?  What effect would a 20% decrease in funds have?
• How do psychiatric hospital unit designs influence the incidence of patients’ aggression?
• What are Native American patient preferences regarding the timing, location and costs for weight management counseling and how will meeting these preferences influence participation?
•  What predicts registered nurse retention in the US Army?
• How, if at all, are the timing and location of suicide prevention appointments linked to veterans‘ suicide rates?
• What predicts the sustainability of quality improvement programs in operating rooms?
• Do integrated computerized nursing records across points of care improve patient outcomes?
• How many nurse practitioners will the US need in 2020?

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DISTINCTIONS

Writing for Healthcare Professionals: Creating a Research Question

• Finding Sources
• Creating a Research Question
• Search Terms
• Search Strategies
• Recording Your Research
• Journal Articles
• Books & Other Sources
• Online Help
• Publisher URL

Choosing a Topic

Sometimes the most difficult part of the research process is choosing a topic.  Here are some tips for selecting a research question that you will enjoy learning about and will ultimately lead to a good grade.

• Read through your assignment.   Professors design an assignment outline for a reason.  Make sure your topic can and will adhere to their requirements and guidelines.
• Choose a topic you are interested in.   If you don't like what you're researching, chances are you won't learn a whole lot or enjoy the process.  And really, what's the point of that?  
• Browse resources that relate to your course work.  Look through a newspaper, magazine, or database for current events or hot topics.  Browsing can spark a lot of great ideas and can help you refine your topic.
• Ask for help!   There is nothing wrong with asking your professor or a librarian to help you brainstorm ideas.

Where to Start

The links below are great places to start in developing a research question.  Browsing current events and hot topics can spark your interest and inspire a topic.

• Alvernia's "Opposing Viewpoints" Collection
• Alvernia's Reference Collection
• Anatomy & Physiology
• Athletic Training Websites
• Google Trends
• Health & Medicine
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• Pew Research Center
• Public Agenda's Programs and Reports

How to Formulate an Answerable Clinical Question

P opulation/patients

I ntervention/indicator

C omparator/control

• P I C O: Formulate an Answerable Question
• Formulating Answerable Clinical Questions

Developing your Research Question

Try asking yourself these questions to help develop a research question:

Topic:  Obesity

Who?  teenagers

What?  consumption of high fat foods

Where?  school cafeterias

Question :  How does the consumption of high fat foods in school cafeterias contribute to teenager obesity?

Topic: Smoke Exposure

Who?   children exposed to smoke

What?   developmental abilities

Question :  How does smoke exposure alter the developmental abilities of children?

Below is worksheet which will help illustrate how a research question develops from a broad topic to a focused question.  This could be a helpful resource for you during the process of creating your research question.

• Creating a Research Question Helps you to write a narrow, focused research question.

Subject Terms to Consider

Below is a list of subjects that often  relate to nursing issues .  Considering these subject terms can help you  develop a topic  or  focus your search .

• Nursing research
• Evidence-based nursing

Helpful Tools

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INTRODUCTION

Stage 1: selecting and exploring a science field, stage 2: writing structured research questions, stage 3: assessing and selecting research questions, how to build and assess the quality of healthcare-related research questions.

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Sergio Ramón Gutiérrez Ubeda; How to Build and Assess the Quality of Healthcare-Related Research Questions. Global Journal on Quality and Safety in Healthcare 1 May 2022; 5 (2): 39–43. doi: https://doi.org/10.36401/JQSH-21-17

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The objective of this article is to describe a simplified process for building and assessing the quality of healthcare-related research questions. This process consisted of three stages. The first stage aimed to select and explore a field of science. This field would be the area for which to identify outputs, such as units of analysis, variables, and objectives. The second stage aimed to write structured research questions, taking into account the outputs of the first stage. In general, the structure of research questions starts with interrogative adverbs (e.g., what and when ), auxiliary verbs (e.g., is there and are there ), or other auxiliaries (e.g., do , does , and did ); followed by nouns nominalized from verbs of research objectives, such as association , correlation , influence , causation , prediction , application ; research variables (e.g., risk factors, efficiency, effectiveness, and safety); and units of analysis (e.g., patients with hypertension and general hospitals). The third stage aimed to assess the quality and feasibility of the research questions against a set of criteria such as relevance, originality, generalizability, measurability, communicability, availability of resources, and ethical issues. By following the proposed simplified process, novice researchers may learn how to write structured research questions of sound scientific value.

A critical factor for the success of research projects is selecting research questions of good quality. [ 1 , 2 ] Research questions are meant to address knowledge gaps and generate hypotheses (e.g., unknown and controversial knowledge). Research projects answer such questions through the application of the scientific method.

Novice researchers who are inexperienced and untrained in the steps and procedures of the scientific method may not know how to develop a research question of high value in an efficient manner. [ 1 , 3 ] . Even if novice researchers try to self-educate themselves on the processes of identifying research questions, they might fail to learn well because of the large body of literature published on the subject. The task of building research questions is time-consuming and challenging.

The objective of this article is to provide a simplified process aimed to build and assess the quality of healthcare-related research questions. The process is explained in three stages, step by step, for novice researchers who will design and conduct research projects on their own and publish their results in peer-reviewed journals. An overview of the process is illustrated in Figure 1 .

Overview of process to build and assess the quality of healthcare-related research questions.

Step 1: Selecting a science field

The task of step 1 is to select one field of science to study. A science field, simply defined, is a subject area targeted for research purposes by scientific communities. Classifications of science fields are potential sources for identifying such fields. For example, the Qatar National Research Foundation [ 4 ] classifies science into broad fields such as natural sciences, engineering and technology, medical and health sciences, agricultural sciences, social sciences, and humanities. They further classify such broad fields into fields of intermediate size. For example, they classify the medical and health sciences field into health sciences, basic medicine, clinical medicine, medical biotechnology, and other medical sciences. Finally, they classify intermediate size fields into smaller fields. For example, they classify the health science field into hospital administration, health policy, nursing, nutrition, dietetics, public health, environmental health, tropical medicine, epidemiology, occupational health, social biomedical health, and so forth.

Whether you select the science field provided by someone else or from your own knowledge, look for evidence (e.g., articles published in peer-reviewed journals) supporting its scientific legitimacy. Often, this evidence is easy to find because scientists and editors from research centers and scientific journals publish definitions and descriptions of their fields of interest on web pages, in journal articles, [ 5 ] and on research agendas. [ 2 ] If such evidence is difficult to find, then try an internet keyword query, such as the following. First, identify the keywords or phrases that you believe are names of science fields. Then, if necessary, combine your keywords or phrases with one or more of the following terms: science , research , research agenda , research center , research at World Health Organization , international forum , and journal . Second, add quotation marks around keywords or phrases and enter them into an internet search engine. Finally, review a few (e.g., 10) of the first hits of the search engine results pages, especially those that match the query phrase, looking for evidence indicating the legitimacy of the science field. For example, I identified the keywords healthcare quality and combined it with the word journal into healthcare quality journal . Then I added quotation marks in the Google search engine. The search produced 13,800 pages. I found a peer-reviewed journal on healthcare quality among the first 10 pages. With this evidence, I felt confident about the legitimacy of the science field named healthcare quality . If there are various science fields of interest, prioritize one that you believe has social relevance, feasibility (e.g., technical, material, financial), and a low risk of ethical issues for research purposes.

Step 2: Identifying units of analysis (UAs)

The two tasks of step 2 are, first, to identify, from the perspective of the science field selected at step 1, potential UAs of interest for scientific inquiry, and second, to select one or a few of them. The UA is a definable and measurable entity, either natural or social, for which projects seek to answer research questions. There are two main purposes for developing a list of UAs. The first purpose is to promote a novice researcher's awareness that within a science field there are several types of UAs. In medicine, for example, this awareness would help the researcher to consider not only patients but also other types of UAs for research projects. The second purpose is to raise awareness of the possibility of building research questions for studies that target not only one but two or more UAs, as in multilevel analysis studies. Four tips on how to develop the list of UAs are given below.

The first tip is to identify UAs based on published lists or classification systems of UAs. For example, one published list of UAs includes control projects; single patients; single clinicians; clinics; populations of patients in nursing homes, hospital wards, microsystems, or entire hospitals. [ 6 ] Babbie [ 7 ] classifies UAs into five categories: individuals, groups, organizations, social interactions, and social artifacts. Lofland [ 8 ] classifies UAs for social science fields in cultural practices, episodes, encounters, roles, social and personal relationships, groups and cliques, organizations, settlements and habitats, and subcultures and lifestyles. Table 1 lists UAs related to the field healthcare quality.

Example units of analysis for the field of healthcare quality

The second tip is to use specific phrases to distinguish between UAs. For example, the phrase individual humans includes all humans, but the phrase human with diabetes type I above 40 years old is specific enough to include only humans who meet those criteria. Other examples of criteria to distinguish between groups of humans would include a specific condition or disease such as hypertension, diabetes, dengue; behaviors such as physical activity, diet, sexual practices; functions and capabilities such as attention, memory, and judgment; and sociodemographic characteristics such as age, ethnicity, religion, and marital status.

The third tip is to list several UAs that are homogeneous, especially when there is interest in analyzing consolidated data, as in quantitative studies. A hint to help understand the homogeneous population UA would be to examine the standard “production” process of each unit. On one hand, UAs such as goods (e.g., vaccines) mass produced with standardized industrial processes are quite homogenous. On the other hand, UAs such as social constructs (e.g., neighborhoods) are usually not homogenous because they grow spontaneously by social processes, often with few limitations and flexible constraints. Neighborhoods, for example, might vary in size, social composition, economic status, and so on, even neighborhoods that have grown in the same city.

The fourth tip is to include UAs that represent single, small, and large natural or social entities to build research questions for qualitative and quantitative studies. For example, the World Health Organization is a single entity, the number of continents in the world would be a small number, whereas the number of cities in the world would be a large number. In quantitative studies, the inferential power of statistical analysis of a small sample of UAs may be compromised.

The second part of step 2 is selecting one or a few UAs to focus on developing in step 3, which is to list variables related to each UA. Prioritize UAs of social relevance, feasibility (e.g., technical and financial), and low risk of ethical issues for research purposes.

Step 3: Identifying research variables and phenomena

The task of step 3 is to create a list of variables and phenomena related to each UA selected in step 2. Variables are measurable features of UAs whose values would vary depending on changing situations. Phenomena describe the meaning, interpretation, or explanation related to variables of the UA. [ 9 , 10 ]

At this step, researchers should be aware of the broad array of variables and phenomena related to each UA. A research project might be conducted with one, two, or more variables, depending on what research questions the project seeks to answer. With a longer list of variables, there are more possibilities to build univariate, bivariate, and multivariate research-related questions. Table 2 illustrates an example of UAs and variables related to the field of healthcare quality. Below are three tips on how to develop a list of variables and phenomena.

Example units of analysis and variables for the field of healthcare quality

The first tip is to search variables and phenomena, one by one, through an extensive literature search for relevant scientific publications. During your search, keep in mind that publications of quantitative approaches often use the term variable , but publications of qualitative approaches might use other terms (e.g., phenomena ). [ 9 , 10 ] This difference might be because “qualitative research aims to understand the how and why of certain behaviors, decisions, and individual experiences” [ 9 ] and such understanding is not measured numerically.

The second tip is to identify a useful framework to classify different variables. For example, Lofland's [ 8 ] typology of questions might help to classify variables and phenomena by type, frequency, magnitude, structure, process, cause, consequence, and agency. Another classification, promoted from the field of quality management systems, [ 11 ] includes six categories of variables: physical (e.g., physical activity, safety of drugs, effectiveness of surgical procedures); sensory (e.g., vision, smell, hearing); behavioral (e.g., courtesy, honesty, veracity); temporal (e.g., punctuality, reliability, availability); ergonomic (e.g., physiological characteristics or related to human safety); and functional (e.g., speed of emergency care).

The third tip is to consider each variable, either simple or complex, as one unit. Simple variables can be measured with just one indicator (i.e., age, sex). Complex variables are usually divided into several dimensions (e.g., patient safety culture may be divided into teamwork and communication), each of which might be measured with multiple indicators. If a researcher adds complex variables and their dimensions as separate units in the same list, the total number of variables becomes inflated, which may overcomplicate the analysis.

Step 4: Identifying possible research objectives

The task of step 4 is to develop a list of possible objectives of interest for the research project. A research objective is the expected outcome that a research project seeks to achieve. Research objectives clarify whether a project seeks to describe one or more variables and phenomena or to study how two or more variables relate to each other (e.g., exposure, intervention, mediating, and outcome variables).

Objectives and research questions are closely related. Thus, developing a list of objectives would help develop a list of research questions. Objectives are often classified into generic categories, such as exploratory, descriptive, correlational, explicative, predictive, and applicative. Exploratory objectives aim to discover, understand, and characterize phenomena and their interactions with other phenomena. Descriptive objectives aim to count frequencies of variables without making comparisons. Correlational objectives aim to assess how one or more variables behave while interacting with each other. Explicative objectives aim to study cause and effect relationships among variables. Predictive objectives aim to forecast the behavior of one variable through understanding the behavior of other variables. Applicative objectives aim to study the effectiveness of interventions on changing other variables' status and behaviors. Table 3 illustrates an example of a UAs with variables, objectives, and research questions related to healthcare quality.

Examples of research questions related to hospitals (UA) and healthcare quality (science field)

The task of the second stage is to build a list of possible research questions for the project. A research question is “a logical statement that progresses from what is known or believed to be true to that which is unknown and requires validation.” [ 12 ] A research question clarifies the specific knowledge that a research project expects to discover through the study of one or a few variables or phenomena related to one or a few UAs.

In general, the structure of research questions would include interrogative adverbs (e.g., what, why, who, when, and where), auxiliary verbs (e.g., is there and are there), or other auxiliaries (e.g., do, does, and did); nouns nominalized from verbs of research objectives, such as association, correlation, causation, prediction, and application; research variables (e.g., incidence, prevalence, risk factors, causes, effects, and interventions); and UAs (e.g., patients with hypertension, mothers, pregnant women with diabetes, and general hospitals). Research questions related to prognosis and relationships between interventions and outcomes would be structured in formats such as those outlined in Table 4 . [ 1 , 3 , 9 , 10 ]

Examples of framework used to write research questions

To write structured research questions, use the outputs of the first stage (e.g., UA list, variables, and objectives) and general or specific formats for structuring research questions. Table 3 includes examples of research questions.

Step 1: Assessing the quality and feasibility of a research question

The task of this step is to assess the quality of the research question against a set of criteria, such as those shown in Figure 2 . A more detailed discussion on such criteria is provided elsewhere. [ 2 , 3 , 13 , 14 ] Other criteria to assess the quality of research questions include answerability, effectiveness, innovativeness, implementation, burden reduction, and equity., [ 2 ] Researchers may also use criteria based on the acronyms, FINER (feasible, interesting, novel, ethical, and relevant) [ 1 , 3 ] and I-SMART (important, specific, measurable, achievable, relevant, and timely). [ 14 ] Rank the quality and feasibility of the criteria using a scale of 1–10 points (i.e., 10 being highest quality and 1 being lowest). Remember to ensure that each criterion is scored using the same scale. Finally, calculate the total score for the research question.

Examples of criteria used to assess the quality of research questions.

Step 2: Selecting the research question

Select the research questions that score highest in the quality assessment from the previous step. Avoid selecting high-risk ethical questions, regardless of other criteria that had high scores. Finally, if answering a research question is not feasible (e.g., too expensive or complex) with the available resources, then that question might be kept on standby until the circumstances for feasibility improve.

Building a research question of high quality just by guessing is unlikely, especially for novice researchers who do not have any training in the scientific method.

The proposed simplified process aimed to help novice researchers write structured, high quality research questions. The key concepts and framework of the scientific method presented illustrate the myriad of questions that researchers can develop in any field of science. The importance of using a well-known set of criteria to assess the quality of research questions was highlighted. This simplified process teaches novice researchers how to build research questions of sound scientific value in a systematic way.

Source of Support: None. Conflict of interest: None.

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How to Build and Assess the Quality of Healthcare-Related Research Questions

Affiliation.

• 1 Center of Investigation and Study of Health, National Autonomous University of Nicaragua, Managua, Nicaragua.
• PMID: 37260836
• PMCID: PMC10229003
• DOI: 10.36401/JQSH-21-17

The objective of this article is to describe a simplified process for building and assessing the quality of healthcare-related research questions. This process consisted of three stages. The first stage aimed to select and explore a field of science. This field would be the area for which to identify outputs, such as units of analysis, variables, and objectives. The second stage aimed to write structured research questions, taking into account the outputs of the first stage. In general, the structure of research questions starts with interrogative adverbs (e.g., what and when ), auxiliary verbs (e.g., is there and are there ), or other auxiliaries (e.g., do , does , and did ); followed by nouns nominalized from verbs of research objectives, such as association , correlation , influence , causation , prediction , application ; research variables (e.g., risk factors, efficiency, effectiveness, and safety); and units of analysis (e.g., patients with hypertension and general hospitals). The third stage aimed to assess the quality and feasibility of the research questions against a set of criteria such as relevance, originality, generalizability, measurability, communicability, availability of resources, and ethical issues. By following the proposed simplified process, novice researchers may learn how to write structured research questions of sound scientific value.

Keywords: healthcare; quality of research questions; writing research questions.

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AI improves accuracy of skin cancer diagnoses in Stanford Medicine-led study

Artificial intelligence algorithms powered by deep learning improve skin cancer diagnostic accuracy for doctors, nurse practitioners and medical students in a study led by the Stanford Center for Digital Health.

April 11, 2024 - By Krista Conger

Artificial intelligence helped clinicians diagnose skin cancer more accurately, a Stanford Medicine-led study found. Chanelle Malambo/peopleimages.com   -  stock.adobe.com

A new study led by researchers at Stanford Medicine finds that computer algorithms powered by artificial intelligence based on deep learning can help health care practitioners to diagnose skin cancers more accurately. Even dermatologists benefit from AI guidance, although their improvement is less than that seen for non-dermatologists.

“This is a clear demonstration of how AI can be used in collaboration with a physician to improve patient care,” said professor of dermatology and of epidemiology Eleni Linos , MD. Linos leads the Stanford Center for Digital Health , which was launched to tackle some of the most pressing research questions at the intersection of technology and health by promoting collaboration between engineering, computer science, medicine and the humanities.

Linos, associate dean of research and the Ben Davenport and Lucy Zhang Professor in Medicine, is the senior author of the study , which was published on April 9 in npj Digital Medicine . Postdoctoral scholar Jiyeong Kim , PhD, and visiting researcher Isabelle Krakowski, MD, are the lead authors of the research.

“Previous studies have focused on how AI performs when compared with physicians,” Kim said. “Our study compared physicians working without AI assistance with physicians using AI when diagnosing skin cancers.”

AI algorithms are increasingly used in clinical settings, including dermatology. They are created by feeding a computer hundreds of thousands or even millions of images of skin conditions labeled with information such as diagnosis and patient outcome. Through a process called deep learning, the computer eventually learns to recognize telltale patterns in the images that correlate with specific skin diseases including cancers. Once trained, an algorithm written by the computer can be used to suggest possible diagnoses based on an image of a patient’s skin that it has not been exposed to.

Eleni Linos

These diagnostic algorithms aren’t used alone, however. They are overseen by clinicians who also assess the patient, come to their own conclusions about a patient’s diagnosis and choose whether to accept the algorithm’s suggestion.

An accuracy boost

Kim and Linos’ team reviewed 12 studies detailing more than 67,000 evaluations of potential skin cancers by a variety of practitioners with and without AI assistance. They found that, overall, health care practitioners working without aid from artificial intelligence were able to accurately diagnose about 75% of people with skin cancer — a statistical measurement known as sensitivity. Conversely, the workers correctly diagnosed about 81.5% of people with cancer-like skin conditions but who did not have cancer — a companion measurement known as specificity.

Health care practitiones who used AI to guide their diagnoses did better. Their diagnoses were about 81.1% sensitive and 86.1% specific. The improvement may seem small, but the differences are critical for people told they don’t have cancer, but do, or for those who do have cancer but are told they are healthy.

When the researchers split the health care practitioners by specialty or level of training, they saw that medical students, nurse practitioners and primary care doctors benefited the most from AI guidance — improving on average about 13 points in sensitivity and 11 points in specificity. Dermatologists and dermatology residents performed better overall, but the sensitivity and specificity of their diagnoses also improved with AI.

“I was surprised to see everyone’s accuracy improve with AI assistance, regardless of their level of training,” Linos said. “This makes me very optimistic about the use of AI in clinical care. Soon our patients will not just be accepting, but expecting, that we use AI assistance to provide them with the best possible care.”

Jiyeong Kim

Researchers at the Stanford Center for Digital Health, including Kim, are interested in learning more about the promise of and barriers to integrating AI-based tools into health care. In particular, they are planning to investigate how the perceptions and attitudes of physicians and patients to AI will influence its implementation.

“We want to better understand how humans interact with and use AI to make clinical decisions,” Kim said. 

Previous studies have indicated that a clinician’s degree of confidence in their own clinical decision, the degree of confidence of the AI, and whether the clinician and the AI agree on the diagnosis all influence whether the clinician incorporates the algorithm’s advice when making clinical decisions for a patient.

Medical specialties like dermatology and radiology, which rely heavily on images — visual inspection, pictures, X-rays, MRIs and CT scans, among others — for diagnoses are low-hanging fruit for computers that can pick out levels of detail beyond what a human eye (or brain) can reasonably process. But even other more symptom-based specialties, or prediction modeling, are likely to benefit from AI intervention, Linos and Kim feel. And it’s not just patients who stand to benefit.

“If this technology can simultaneously improve a doctor’s diagnostic accuracy and save them time, it’s really a win-win. In addition to helping patients, it could help reduce physician burnout and improve the human interpersonal relationships between doctors and their patients,” Linos said. “I have no doubt that AI assistance will eventually be used in all medical specialties. The key question is how we make sure it is used in a way that helps all patients regardless of their background and simultaneously supports physician well-being.”

Researchers from the Karolinska Institute, the Karolinska University Hospital and the University of Nicosia contributed to the research.

The study was funded by the National Institutes of Health (grants K24AR075060 and R01AR082109), Radiumhemmet Research, the Swedish Cancer Society and the Swedish Research Council.

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About Stanford Medicine

Stanford Medicine is an integrated academic health system comprising the Stanford School of Medicine and adult and pediatric health care delivery systems. Together, they harness the full potential of biomedicine through collaborative research, education and clinical care for patients. For more information, please visit med.stanford.edu .

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Research explores how a father's diet could shape the health of his offspring

New research, published in Nature Communications , finds that the macronutrient balance in the diet of male mice affects the level of anxiety-like behaviour of sons and the metabolic health of daughters.

The research provides a step towards understanding how the effect of diet can transmit from one generation to the next via a father's sperm. It could ultimately inform dietary guidelines for fathers-to-be, with the goal of lowering the risk of metabolic disease and mood disorders in the next generation.

Parents like to believe they can shape the interests and behaviour of their children, with mixed success. But a new study from an international team of researchers confirms this is the case for mice, with father's shaping their offspring's health through their own diet.

Scientists have already discovered that a mouse father's diet can have an impact not only on his own reproductive health but on that of his offspring. Over- or under-feeding male mice can affect their offspring's metabolism and behaviour, as well as their risk of cancer. What is less understood is whether there are diverse types of health impacts on the health of offspring, depending on the type and composition of the diet of male mice before conception.

This was the starting point for the research by scientists in the international GECKO consortium, with lead investigators in Copenhagen, Sydney, and Chicago.

At the University of Sydney's Charles Perkins Centre in Australia researchers fed male mice one of ten diets differing in the proportions of protein, fats, and carbohydrates, then allowed them to mate with females reared on standard diet. The behaviour and physiology of the resulting pups were then studied.

Dietary composition as important as number of calories

The scientists discovered that male mice fed low protein and high carbohydrate diets were more likely to have male offspring with higher levels of anxiety, as measured by time spent in the safety zones of their maze. They also found that male mice that were fed high fat diets were more likely to have daughters with higher levels of body fat and markers of metabolic disease.

"Our study shows that the type of diet eaten before conception can program specific characteristics of the next generation," says co-senior author and leader of the GECKO consortium Professor Romain Barrès, from the University of Copenhagen and Université Côte d'Azur, Nice.

"It is extraordinary that by titrating mixtures of protein, fat and carbs in the father's diet we could influence specific features of his sons and daughters health and behaviour. There is some important biology at play here," said Professor Stephen Simpson, co-senior author and Academic Director of the Charles Perkins Centre at the University of Sydney.

The team also observed that males on a low protein diet also ate more food overall. However, thanks to the study design, they could determine that both the amount of calories, and the macronutrient composition of the males' diets, influenced the health of their offspring.

"Our study shows that it's not just eating too much or too little, but the composition of the diet that can have an impact on future children," says Professor Romain Barrès.

The work was conducted in mice and has opened the way for the team to study the molecular mechanisms involved. The mouse work is part of a broader series of studies within the GECKO consortium, involving humans and other mammals at partner institutions.

"We think our study is a step towards establishing dietary guidelines for fathers to be, with the ultimate goal of lowering the risk of metabolic disease and mood disorders in the next generation," says Professor Romain Barrès.

• Diet and Weight Loss
• Cholesterol
• Mating and Breeding
• Healthy diet
• Health science
• Atkins Diet
• Epidemiology
• Personalized medicine
• House mouse
• Separation anxiety disorder

Story Source:

Materials provided by University of Sydney . Note: Content may be edited for style and length.

Journal Reference :

• Angela Jane Crean, Alistair McNair Senior, Therese Freire, Thomas Daniel Clark, Flora Mackay, Gracie Austin, Tamara Jayne Pulpitel, Marcelo Aguiar Nobrega, Romain Barrès, Stephen James Simpson. Paternal dietary macronutrient balance and energy intake drive metabolic and behavioral differences among offspring . Nature Communications , 2024; 15 (1) DOI: 10.1038/s41467-024-46782-y

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The unexpected health benefits of Ozempic and Mounjaro

Research is showing that these new weight-loss drugs can help treat conditions from addiction to kidney disease—and may even be contributing to a boom of “Ozempic babies.”

Casey Arnold, who lives in a suburb of Houston, spent years trying to quit smoking. She’d tried nicotine patches. That failed. She tried quitting cold turkey but that made her short tempered. On other occasions the idea of quitting made her so anxious, she smoked more to ease her fears.

By the time she permanently gave up cigarettes in the winter of 2023, at age 55, she’d been smoking for four decades and was up to two packs a day. But this time it was a new type of weight loss drug that helped her quit.

GLP-1, short for glucagon-like peptide 1, is a natural hormone that stimulates the production and release of insulin, slows digestion, curbs appetite, and blunts the brain’s focus on food. GLP-1 agonist drugs, like exanetide, tirzepatide and semaglutide, mimic this hormone. They were originally developed as diabetes treatments, but as more people began taking them, researchers observed these medications are effective for many more conditions than just diabetes and weight loss.

The FDA recently approved semaglutide, the active ingredient of Wegovy, for the treatment of obesity and for reducing the risk of heart attack and stroke in patients with obesity and heart disease . But as the number of people taking these drugs grows, physicians and researchers are learning about unanticipated health benefits for conditions where treatments have been limited, such as addiction, heart failure, and kidney disease.

( Ozempic is a serious drug with serious risks. Here’s what to know. )

Arnold quit smoking while participating in a clinical trial examining the potential of GLP-1 agonists as a treatment for smoking addiction.

“It was totally opposite of when I tried to quit in my previous years,” Arnold says. “I was shocked at how calm I was, compared to how I used to think about quitting.” Instead of anxiety and rage, she felt at peace, and her cravings faded.

“It’s just been an avalanche across the different patient populations,” says Mark Petrie , a cardiologist at the University of Glasgow, whose research focuses on the use of GLP-1 agonists in patients with heart failure. “It’s just good news all around.”

Heart failure with preserved ejection fraction

More than six million Americans are living with heart failure , a condition where the heart progressively loses the ability to pump enough blood to the rest of the body. Of these patients, approximately half have a type known as heart failure with preserved ejection fraction , in which the heart can pump normally but is too stiff to fill up with blood.

In a study published last year , researchers tested semaglutide as a treatment for heart failure with preserved ejection fraction in patients who were not diabetic. The result: patients who received the drug showed fewer symptoms and reported a better quality of life, compared to those who received the placebo. Patients who received the drug had lower levels of C-reactive protein, which is a marker for inflammation.

“This is a big finding,” says James de Lemos, a cardiologist at UT Southwestern Medical Center, in Dallas, Texas, who was not associated with the study. The study was too small to determine if semaglutide can reduce the risk of hospitalization or death but given the stark improvement in patient quality of life, it’s promising.

Although some of these benefits are likely due to weight loss, that’s just part of what makes this treatment effective.

These medications are also cardioprotective and reduce inflammation, which is known to be a driver of heart failure, says Amanda Vest , a cardiologist at the Cleveland Clinic, who specializes in treating patients with heart failure. “We must continue to think more expansively than just about the number on the scale,” Vest says.

For patients with the other major type of heart failure—heart failure with reduced ejection fraction—there is less evidence, so far, that these drugs are effective. More trials are in the works to determine which types of patients will benefit from the use of these medications.

Kidney disease

An estimated 850 million people worldwide are living with chronic kidney disease ,   but there are few effective treatments. Historically, the main strategy has been to stall kidney failure for as long as possible and then move the patient to dialysis or wait for a kidney transplant. But nine out of 10 patients die of complications before reaching that point.

For patients with severe chronic kidney disease, “you are looking at a mortality rate that’s 10 to 20 percent a year,” says Katherine Tuttle , a nephrologist at the University of Washington Medicine. “This is on par with the worst malignancies.”

As a couple of recent studies have shown , the GLP-1 agonist dulaglutide helps patients who suffer from chronic kidney disease and diabetes. In a recent trial looking at the effect of semaglutide on patients with chronic kidney disease and type 2 diabetes, the treatment was so effective at delaying the progression of chronic kidney disease that the clinical trial was stopped early so that all the trial patients could benefit from the drug.

“It’s the only semaglutide trial that was stopped early for efficacy,” says Tuttle, who is on the executive committee for the trial. “To stop a trial early for efficacy, the bar is set really high,” which includes strong enough evidence for its efficacy that it would be no longer considered ethical to continue giving patients the placebo.

( New obesity drugs are coming. Here's how they could change everything. )

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As Tuttle notes, the effects on the kidneys is only partially due to reductions in risk factors such as blood pressure, blood sugar, and weight. Other benefits are likely to result from reduced inflammation.

“They have a profound anti-inflammatory effect,” Tuttle says. “Our field is really under recognizing the importance of inflammation, particularly in kidney damage caused by diabetes.”

Results from the trial will be published later this year.

Effects on fertility

For a growing number of patients on GLP-1 agonists, such as Ozempic or Mounjaro, one surprising side effect has been unexpected pregnancy, which for some patients, has come after years of struggling with infertility. Although more research is needed to explore the link between GLP-1 agonists and pregnancy, it’s become enough of a phenomenon that ‘Ozempic babies’ has become a trending phrase. Meanwhile, experts think there are several factors responsible.

The first factor is the fact that GLP-1 agonists cause a delayed gastric emptying, which can cause oral contraception pills to be absorbed by the body at a slower rate. “These drugs are altering that particular part of the drug absorption phase,” says Archana Sadhu , an endocrinologist at Houston Methodist Hospital, adding that this effect can be particularly prominent during dosage increases. This means that oral birth control may not be as effective.

The second factor is the link between polycystic ovarian syndrome (PCOS)—the leading cause of infertility in women—and insulin resistance.

“Insulin resistance will dysregulate the ovarian cycle,” Sadhu says. Insulin resistance can lead to infertility by disrupting hormones such as estrogen and testosterone, which are related to fertility; and it can affect the release of eggs from the ovaries. When patients start taking GLP-1 agonists, this reduces their insulin resistance, which boosts fertility.

However, the effects of these drugs on pregnancy are still unknown, which means that it’s important for patients to talk with their doctors about any plans for becoming pregnant, as well as strategies for contraception, which may include adding in a second method to augment oral contraceptive pills, or switching to a different method.

Treating addiction

Since Ozempic and Mounjaro have been become more common, patients have been reporting several unexpected side effects, such as a diminished desire to smoke or drink. Although more research is needed, it’s thought that the part of the brain that is responsible for food cravings overlaps with the part of the brain that is responsible for cravings for substances of abuse, says Luba Yammine, an addiction researcher at UTHealth Houston.

For doctors working in the field, earlier versions of these GLP-1 drugs showed tremendous potential as anti-addiction medications.

“We have far fewer medications available” for treating addiction and many patients report difficulties accessing these, says Christian Hendershot, an addiction researcher at the University of North Carolina School of Medicine. The field also receives less research funding compared with other diseases.

For Yammine, she first became interested in studying the effect of GLP-1 agonists on addiction while working in primary care, where she had several patients who were smokers with diabetes. Yammine would counsel her patients on quitting smoking, prescribing nicotine patches or the medication buproprion, to help them quit. But most of the time these strategies failed.

“It’s hard to quit smoking, period,” Yammine says. “The vast majority of smokers want to quit, but even with the use of these therapies, many of them are not successful.”

To help these smokers with their diabetes she would prescribe GLP-1 agonist medications, only to discover when they returned for a follow-up that they had quit smoking. When she asked them what happened, their answer was that suddenly their cravings vanished. “That was a very interesting finding,” Yammine says.

This happened often enough that Yammine decided to explore the impact of these GLP-1 receptor agonists on addiction through a clinical trial.

Yammine and her collaborators led a pilot study , in which 46 percent of the participants who received exanetide, plus nicotine patches and smoking cessation counseling, were able to quit, compared to 26 percent of participants who received nicotine patches, counseling, and a placebo. Yammine and her collaborators are now following up with a larger trial. They are also planning a separate trial with semaglutide.

For the patients in the study who received exanetide, their post-cessation weight was 5.6 pounds lower than those who received the placebo, a side effect that can help offset the weight gain that is often associated with quitting smoking.  

“This weight gain is very problematic,” Yammine says, adding that many patients are either afraid to quit or relapse due to concerns about weight gain, while it can also put them at heightened risk for developing weight-related conditions, such as type 2 diabetes.

For Arnold, who was enrolled in a follow up trial that Yammine is conducting, the months in which she was participating in the trial was characterized both by a calmness surrounding her efforts to quit, as well as minimal weight gain. Since the trial has ended, she’s been able to maintain her efforts to quit smoking, although she gained a little weight. “I don’t have cravings,” Arnold says. “It’s this weight gain that is bothering me.”

Arnold, who works for an HVAC company, would really like to go back on exanetide, but as is the case with so many other patients who have experienced benefits from GLP-1 receptor agonists, she’s finding that it’s too expensive to do so. Just one month’s supply costs about $1,000, and without FDA approval for its use as an anti-addiction drug, most health insurance companies won’t pay for it.

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An artificial womb could build a bridge to health for premature babies

Surgeon Christoph Haller and his research team from Toronto's Hospital for Sick Children are working on technology that could someday result in an artificial womb to help extremely premature babies. Chloe Ellingson for NPR hide caption

Surgeon Christoph Haller and his research team from Toronto's Hospital for Sick Children are working on technology that could someday result in an artificial womb to help extremely premature babies.

TORONTO — A surgical team scurries around a pregnant female pig lying unconscious on an operating table. They're about to take part in an experiment that could help provide a new option to help premature babies survive.

"The ultimate goal of today is to transition a fetus onto that artificial womb," says Dr. Christoph Haller , motioning to a clear rectangular plastic sack with tubes running in and out of it.

"We're transitioning it into an artificial environment that allows the fetus to still maintain its regular physiology," says Haller, a pediatric heart surgeon at The Hospital for Sick Children.

Today, it's a pig fetus that Haller and his colleagues will be using to test their artificial womb. But their hope is that someday, technology like this will help humans survive extremely premature birth and avoid serious complications, such as blindness and permanent damage to lungs and brains.

A nonprofit says preterm births are up in the U.S. — and it's not a partisan issue

"We're basically trying to find a new concept on how to preserve fetuses to allow them to mature more physiologically compared to the regular preterm. That would be the target — to treat extreme premature babies," says Haller, who's also an assistant professor of surgery at the University of Toronto. "This would hopefully be a big deal — a game changer."

NPR was granted exclusive access to watch Haller's team test their artificial womb.

Research like this is generating enormous excitement among doctors who treat babies who are born prematurely , a major cause of infant mortality and disabilities. But the prospect of an artificial womb is prompting a long list of questions.

"I think it's a really promising and fascinating technology," says Dr. Mark Mercurio , a professor of pediatrics who directs the program for biomedical ethics at the Yale School of Medicine. "But certainly it raises ethical concerns and questions that need to be addressed."

The procedure remains highly experimental

A metal tray next to the pig's belly is covered with blue paper. Haller's team just drew a picture of a pig's face on the paper surrounded by the words "Oink. Oink. Oink." and "We ❤ you." Then they laid out the artificial womb on top of it. Some call this kind of contraption a "biobag."

A technician scans the belly of a pregnant pig before an operation to transfer a fetus to an artificial womb. Chloe Ellingson for NPR hide caption

A technician scans the belly of a pregnant pig before an operation to transfer a fetus to an artificial womb.

Next, the surgical team arranges equipment and examines the 10 fetuses in the sow's womb with an ultrasound. Haller uses a clipper to make some last-minute adjustments to tubing he'll stitch into the fetal pig's umbilical cord.

The tubes will supply the fetus's blood with oxygen, remove carbon dioxide from the blood and supply nutrition and medicine.

"I'm MacGyvering stuff here to make things work," he says with a laugh.

Finally, everyone's ready to remove one of the fetuses.

"All right, I think we're going to get started," Haller says, prompting the team to gather tightly around the pig.

Wisps of smoke rise from the pig's belly as Haller makes an incision with an electric scalpel. An assistant suctions the area to keep it dry.

Dr. Christoph Haller performs surgery to remove a fetal pig from the adult pig's womb. Chloe Ellingson for NPR hide caption

Dr. Christoph Haller performs surgery to remove a fetal pig from the adult pig's womb.

"So what you're looking at is basically the uterus. And then in here is the fetus. The head's somewhere here, where I have my hand. The rest of the body is still inside," he says.

After deciding which fetus looks best on the ultrasound, Haller makes another incision in the uterus and pulls out a bright pink fetal piglet. The fetus looks peaceful, like it's sleeping.

Once the fetus is completely out, Haller and his team quickly assess its health and cut the umbilical cord so they can transfer the animal into the artificial womb.

A "biobag" becomes the new womb

After gingerly sliding the fetus into the "biobag," Haller quickly attaches the three umbilical cord tubes. His colleagues fill the bag with a clear, warm liquid meant to mimic amniotic fluid and seal the artificial womb.

"It's going to be a bit of a rocky period now," Haller says.

A fetal pig rests inside an artificial womb. Chloe Ellingson for NPR hide caption

A fetal pig rests inside an artificial womb.

The team carefully monitors the fetus's heart rate, blood pressure and other vital signs. Once it looks stable, the researchers surround the biobag with warmers.

"It's as close to a good transition as you can get I think," Haller says. "I'm excited as if it was a proper human surgery I would say — just because I want to get it right and I want to see the fetus doing well there."

This will go on for hours.

"You may see the fetus starting to have breathing-like movements. But that's what's in line with what's happening in utero too — as if they are training basically a bit. You may see that it kicks its legs," Haller says. "That's what we like to see because it signals a certain level of health."

An artificial womb could be a bridge to better health

If very premature babies can be safely sustained on a device like this for just two or three weeks, it could make all the difference between life and death or a life with severe disabilities and health problems or not, Haller says.

The Toronto group has seen blood clots and heart problems develop. So far, they've only been able to sustain a pig fetus for about a week.

But researchers at Children's Hospital of Philadelphia have safely sustained fetal sheep on a very similar device for four weeks, making the Toronto group and others optimistic the approach will eventually work.

"If this artificial womb technology could sustain a patient even for a period of weeks and get them to a later stage and a bigger size, that could potentially be quite a dramatic change in our field," says Dr. Mike Seed , an associate professor of pediatrics at the University of Toronto who is working with Haller.

Scientific progress prompts ethical concerns

But the possibility of an artificial womb is also raising many questions. When might it be safe to try an artificial womb for a human? Which preterm babies would be the right candidates? What should they be called? Fetuses? Babies?

"It matters in terms of how we assign moral status to individuals," says Mercurio, the Yale bioethicist. "How much their interests — how much their welfare — should count. And what one can and cannot do for them or to them."

But Mercurio is optimistic those issues can be resolved, and the potential promise of the technology clearly warrants pursuing it.

The Food and Drug Administration held a workshop in September 2023 to discuss the latest scientific efforts to create an artificial womb, the ethical issues the technology raises, and what questions would have to be answered before allowing an artificial womb to be tested for humans.

"I am absolutely pro the technology because I think it has great potential to save babies," says Vardit Ravitsky , president and CEO of The Hastings Center, a bioethics think tank.

But there are particular issues raised by the current political and legal environment.

"My concern is that pregnant people will be forced to allow fetuses to be taken out of their bodies and put into an artificial womb rather than being allowed to terminate their pregnancies — basically, a new way of taking away abortion rights," Ravitsky says.

She also wonders: What if it becomes possible to use artificial wombs to gestate fetuses for an entire pregnancy, making natural pregnancy unnecessary?

"Science fiction writers have been playing with this notion for decades. It's not like we never thought about it. It's just different to think about it as a thought experiment and to think about it as something that's potentially around the corner," Ravitsky says. "The scenario of a complete use of artificial wombs could become pretty scary, pretty quickly."

But Haller and his colleagues say the darkest worries are unfounded.

Shots - Health News

The u.s. has a high rate of preterm births, and abortion bans could make that worse.

"We've heard people fearing that this translates into women not having to go through a full pregnancy anymore — kind of more like a Matrix -style of dystopian future," Haller says.

"But it would be outrageous to assume that any artificial intervention in any way is better than nature. So if you're not running into problems in your pregnancy, I think there's a lot of evidence that you're better off being born as you should be from what nature intended," he says.

Haller and his colleagues, he says, are just trying to save babies.

"Every tool can be misused," he says. "Like AI — it has its benefits, but if it's not regulated adequately a lot of harm can arise from something like that as well."

Meanwhile, the fetal pig is settling into its new artificial womb.

"I think it looks pretty, pretty comfy and settled," Haller says. "It looks pretty, pretty happy in there. Yeah, it's good."

• premature mortality
• premature birth
• medical technology

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• v.53(4); 2010 Aug

Research questions, hypotheses and objectives

Patricia farrugia.

* Michael G. DeGroote School of Medicine, the

Bradley A. Petrisor

† Division of Orthopaedic Surgery and the

Forough Farrokhyar

‡ Departments of Surgery and

§ Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont

Mohit Bhandari

There 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 evidence-based practice. A well-defined and specific research question is more likely to help guide us in making decisions about study design and population and subsequently what data will be collected and analyzed. 1

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.

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 principles should be taken into consideration. 1 All questions, primary and secondary, should be developed at the beginning and planning stages of a study. Any additional questions should never compromise the primary question because it is the primary research question that forms the basis of the hypothesis and study objectives. It must be kept in mind that within the scope of one study, the presence of a number of research questions will affect and potentially increase the complexity of both the study design and subsequent statistical analyses, not to mention the actual feasibility of answering every question. 1 A sensible strategy is to establish a single primary research question around which to focus the study plan. 3 In a study, the primary research question should be clearly stated at the end of the introduction of the grant proposal, and it usually specifies the population to be studied, the intervention to be implemented and other circumstantial factors. 4

Hulley and colleagues 2 have suggested the use of the FINER criteria in the development of a good research question ( Box 1 ). The FINER criteria highlight useful points that may increase the chances of developing a successful research project. A good research question should specify the population of interest, be of interest to the scientific community and potentially to the public, have clinical relevance and further current knowledge in the field (and of course be compliant with the standards of ethical boards and national research standards).

FINER criteria for a good research question

Adapted with permission from Wolters Kluwer Health. 2

Whereas the FINER criteria outline the important aspects of the question in general, a useful format to use in the development of a specific research question is the PICO format — consider the population (P) of interest, the intervention (I) being studied, the comparison (C) group (or to what is the intervention being compared) and the outcome of interest (O). 3 , 5 , 6 Often timing (T) is added to PICO ( Box 2 ) — that is, “Over what time frame will the study take place?” 1 The PICOT approach helps generate a question that aids in constructing the framework of the study and subsequently in protocol development by alluding to the inclusion and exclusion criteria and identifying the groups of patients to be included. Knowing the specific population of interest, intervention (and comparator) and outcome of interest may also help the researcher identify an appropriate outcome measurement tool. 7 The more defined the population of interest, and thus the more stringent the inclusion and exclusion criteria, the greater the effect on the interpretation and subsequent applicability and generalizability of the research findings. 1 , 2 A restricted study population (and exclusion criteria) may limit bias and increase the internal validity of the study; however, this approach will limit external validity of the study and, thus, the generalizability of the findings to the practical clinical setting. Conversely, a broadly defined study population and inclusion criteria may be representative of practical clinical practice but may increase bias and reduce the internal validity of the study.

PICOT criteria 1

A poorly devised research question may affect the choice of study design, potentially lead to futile situations and, thus, hamper the chance of determining anything of clinical significance, which will then affect the potential for publication. Without devoting appropriate resources to developing the research question, the quality of the study and subsequent results may be compromised. During the initial stages of any research study, it is therefore imperative to formulate a research question that is both clinically relevant and answerable.

Research hypothesis

The primary research question should be driven by the hypothesis rather than the data. 1 , 2 That is, the research question and hypothesis should be developed before the start of the study. This sounds intuitive; however, if we take, for example, a database of information, it is potentially possible to perform multiple statistical comparisons of groups within the database to find a statistically significant association. This could then lead one to work backward from the data and develop the “question.” This is counterintuitive to the process because the question is asked specifically to then find the answer, thus collecting data along the way (i.e., in a prospective manner). Multiple statistical testing of associations from data previously collected could potentially lead to spuriously positive findings of association through chance alone. 2 Therefore, a good hypothesis must be based on a good research question at the start of a trial and, indeed, drive data collection for the study.

The research or clinical hypothesis is developed from the research question and then the main elements of the study — sampling strategy, intervention (if applicable), comparison and outcome variables — are summarized in a form that establishes the basis for testing, statistical and ultimately clinical significance. 3 For example, in a research study comparing computer-assisted acetabular component insertion versus freehand acetabular component placement in patients in need of total hip arthroplasty, the experimental group would be computer-assisted insertion and the control/conventional group would be free-hand placement. The investigative team would first state a research hypothesis. This could be expressed as a single outcome (e.g., computer-assisted acetabular component placement leads to improved functional outcome) or potentially as a complex/composite outcome; that is, more than one outcome (e.g., computer-assisted acetabular component placement leads to both improved radiographic cup placement and improved functional outcome).

However, when formally testing statistical significance, the hypothesis should be stated as a “null” hypothesis. 2 The purpose of hypothesis testing is to make an inference about the population of interest on the basis of a random sample taken from that population. The null hypothesis for the preceding research hypothesis then would be that there is no difference in mean functional outcome between the computer-assisted insertion and free-hand placement techniques. After forming the null hypothesis, the researchers would form an alternate hypothesis stating the nature of the difference, if it should appear. The alternate hypothesis would be that there is a difference in mean functional outcome between these techniques. At the end of the study, the null hypothesis is then tested statistically. If the findings of the study are not statistically significant (i.e., there is no difference in functional outcome between the groups in a statistical sense), we cannot reject the null hypothesis, whereas if the findings were significant, we can reject the null hypothesis and accept the alternate hypothesis (i.e., there is a difference in mean functional outcome between the study groups), errors in testing notwithstanding. In other words, hypothesis testing confirms or refutes the statement that the observed findings did not occur by chance alone but rather occurred because there was a true difference in outcomes between these surgical procedures. The concept of statistical hypothesis testing is complex, and the details are beyond the scope of this article.

Another important concept inherent in hypothesis testing is whether the hypotheses will be 1-sided or 2-sided. A 2-sided hypothesis states that there is a difference between the experimental group and the control group, but it does not specify in advance the expected direction of the difference. For example, we asked whether there is there an improvement in outcomes with computer-assisted surgery or whether the outcomes worse with computer-assisted surgery. We presented a 2-sided test in the above example because we did not specify the direction of the difference. A 1-sided hypothesis states a specific direction (e.g., there is an improvement in outcomes with computer-assisted surgery). A 2-sided hypothesis should be used unless there is a good justification for using a 1-sided hypothesis. As Bland and Atlman 8 stated, “One-sided hypothesis testing should never be used as a device to make a conventionally nonsignificant difference significant.”

The research hypothesis should be stated at the beginning of the study to guide the objectives for research. Whereas the investigators may state the hypothesis as being 1-sided (there is an improvement with treatment), the study and investigators must adhere to the concept of clinical equipoise. According to this principle, a clinical (or surgical) trial is ethical only if the expert community is uncertain about the relative therapeutic merits of the experimental and control groups being evaluated. 9 It means there must exist an honest and professional disagreement among expert clinicians about the preferred treatment. 9

Designing a research hypothesis is supported by a good research question and will influence the type of research design for the study. Acting on the principles of appropriate hypothesis development, the study can then confidently proceed to the development of the research objective.

Research objective

The primary objective should be coupled with the hypothesis of the study. Study objectives define the specific aims of the study and should be clearly stated in the introduction of the research protocol. 7 From our previous example and using the investigative hypothesis that there is a difference in functional outcomes between computer-assisted acetabular component placement and free-hand placement, the primary objective can be stated as follows: this study will compare the functional outcomes of computer-assisted acetabular component insertion versus free-hand placement in patients undergoing total hip arthroplasty. Note that the study objective is an active statement about how the study is going to answer the specific research question. Objectives can (and often do) state exactly which outcome measures are going to be used within their statements. They are important because they not only help guide the development of the protocol and design of study but also play a role in sample size calculations and determining the power of the study. 7 These concepts will be discussed in other articles in this series.

From the surgeon’s point of view, it is important for the study objectives to be focused on outcomes that are important to patients and clinically relevant. For example, the most methodologically sound randomized controlled trial comparing 2 techniques of distal radial fixation would have little or no clinical impact if the primary objective was to determine the effect of treatment A as compared to treatment B on intraoperative fluoroscopy time. However, if the objective was to determine the effect of treatment A as compared to treatment B on patient functional outcome at 1 year, this would have a much more significant impact on clinical decision-making. Second, more meaningful surgeon–patient discussions could ensue, incorporating patient values and preferences with the results from this study. 6 , 7 It is the precise objective and what the investigator is trying to measure that is of clinical relevance in the practical setting.

The following is an example from the literature about the relation between the research question, hypothesis and study objectives:

Study: Warden SJ, Metcalf BR, Kiss ZS, et al. Low-intensity pulsed ultrasound for chronic patellar tendinopathy: a randomized, double-blind, placebo-controlled trial. Rheumatology 2008;47:467–71.

Research question: How does low-intensity pulsed ultrasound (LIPUS) compare with a placebo device in managing the symptoms of skeletally mature patients with patellar tendinopathy?

Research hypothesis: Pain levels are reduced in patients who receive daily active-LIPUS (treatment) for 12 weeks compared with individuals who receive inactive-LIPUS (placebo).

Objective: To investigate the clinical efficacy of LIPUS in the management of patellar tendinopathy symptoms.

The development of the research question is the most important aspect of a research project. A research project can fail if the objectives and hypothesis are poorly focused and underdeveloped. Useful tips for surgical researchers are provided in Box 3 . Designing and developing an appropriate and relevant research question, hypothesis and objectives can be a difficult task. The critical appraisal of the research question used in a study is vital to the application of the findings to clinical practice. Focusing resources, time and dedication to these 3 very important tasks will help to guide a successful research project, influence interpretation of the results and affect future publication efforts.

Tips for developing research questions, hypotheses and objectives for research studies

• Perform a systematic literature review (if one has not been done) to increase knowledge and familiarity with the topic and to assist with research development.
• Learn about current trends and technological advances on the topic.
• Seek careful input from experts, mentors, colleagues and collaborators to refine your research question as this will aid in developing the research question and guide the research study.
• Use the FINER criteria in the development of the research question.
• Ensure that the research question follows PICOT format.
• Develop a research hypothesis from the research question.
• Develop clear and well-defined primary and secondary (if needed) objectives.
• Ensure that the research question and objectives are answerable, feasible and clinically relevant.

FINER = feasible, interesting, novel, ethical, relevant; PICOT = population (patients), intervention (for intervention studies only), comparison group, outcome of interest, time.

Competing interests: No funding was received in preparation of this paper. Dr. Bhandari was funded, in part, by a Canada Research Chair, McMaster University.

Emerging Drug Trends

• Emerging drugs, which include designer drugs and new psychoactive substances , are substances that have appeared or become more popular in the drug market in recent years.
• Emerging drugs have unpredictable health effects . They may be as powerful or more powerful than existing drugs, and may be fatal.
• Because drug markets change quickly, NIDA supports the National Drug Early Warning System (NDEWS) , which tracks emerging substances. NIDA also advances the science on emerging drugs by supporting research on their use and on their health effects.

What are emerging drugs?

Emerging drugs are mind-altering substances that have become more common in recent years. They may be sold in drug markets or at convenience stores and online. Since 2013, the United Nations Office on Drugs and Crime has identified more than 1,000 emerging drugs worldwide. 1

These substances, which include designer drugs and new psychoactive substances , come from many sources. Some were first developed as potential treatments or research chemicals. Others originate in illicit labs and are created to mimic the effects of drugs regulated under the Controlled Substances Act . These emerging substances often produce similar effects and/or are chemically similar to illegal or prescription opioids, stimulants, benzodiazapines (“benzos”), or other existing types of drugs.

People may seek out these drugs for recreation or use them to self-medicate without medical supervision. They may also be added to other drugs without a buyer knowing it. As a result, the health effects of emerging drugs are largely unknown, potentially posing a public health threat and contributing to the overdose crisis . 2,3

NIDA monitors emerging drug trends through its Designer Drug Research Unit and through support for the National Drug Early Warning System (NDEWS) , which tracks drug-related emergency calls.

What are the effects of emerging drugs?

An emerging drug’s effects depend on the type of substance it is—for instance, if it is a new type of opioid , depressant , synthetic cannabinoid , psychedelic , or stimulant. Its effects may be unpredictable and unwanted, especially if it is an unknown ingredient in another drug. A person may not know what substance or substances they have really taken. And because these substances are new to the drug market, clinicians or researchers may not know their effects or how potent (powerful) they are until people begin to visit emergency departments or clinics with symptoms of negative health effects. 4

In addition, emerging substances are usually not included in emergency department drug tests and are not routinely included in the toxicology tests used after a fatal overdose. The delay in this data means there is also a delay in understanding how widespread use of the drug is, why and how these drugs have their effects, and how to care for people who experience negative effects of those substances.

NIDA researchers and grantees collaborate to identify how these emerging drugs work and their potential health effects, including those that have the potential to impact the overdose crisis. NIDA also supports the National Drug Early Warning System (NDEWS) to track emerging substances and their impact on drug-related emergency calls.

What are nitazenes?

Nitazenes are a class of lab-made (synthetic) opioids that may be as powerful or more powerful than fentanyl. 4   They were developed in research labs in the 1950s as potential pain relievers but never marketed. Nitazenes are most often sold as a white powder or tablets. People may not be aware that they have taken nitazenes, as they may be added to other substances, including fentanyl, heroin, and benzodiazepines. 5

Nitazenes began to re-emerge in the drug supply in 2019, after the U.S. Drug Enforcement Administration banned fentanyl-related substances. 6,7 Researchers and authorities are monitoring nitazenes, including isotonitazene, protonitazene, etonitazene, N-piperidinyl etonitazene, and metonitazene. Many nitazenes are listed as Schedule 1 drugs under the Controlled Substances Act. 

Like all opioids , nitazenes can slow breathing, blood pressure, and heart rate to dangerously low levels, potentially contributing to overdose . Preliminary NIDA-supported research shows that the opioid overdose reversal medication naloxone is effective with isonitazene, metonitazene, and etonitazene, though it may require repeated doses. More research is needed to confirm these findings with additional nitazenes and in larger groups of people. Fentanyl test strips do not detect nitazenes.

What is tianeptine?

Tianeptine is an antidepressant medication that is not approved for use in the United States. NIDA-funded research suggests that most people take tianeptine in dietary supplements marketed as cognitive enhancers or nootropics, often sold in convenience stores and online. It may be blended with or taken at the same time as other nootropics (like phenibut and racetams) and is also used with substances such as kratom , kava, and gabapentin.

Tianeptine is not an opioid but at high doses it can have opioid-like effects, such as dangerous drops in blood pressure, heart rate, or breathing rate. Research shows that other effects include problems with brain, heart, and digestive function.

Research has shown that tianeptine can cause symptoms of a substance use disorder, including tolerance—which is when you need to take more of a drug for it to have the same level of effect—and withdrawal. Withdrawal from tianeptine has been associated with pain and problems with brain, heart, and digestive function. Early evidence suggests that tianeptine-related substance use disorder can be treated with medications for opioid use disorder , such as buprenorphine. 8

What are new psychoactive substances?

“New psychoactive substances” is a term used to describe lab-made compounds created to skirt existing drug laws . The category may include medications created by pharmaceutical companies or researchers that were never meant to reach the public .

These substances belong to a number of drug classes:

• Synthetic opioids. These drugs are chemically different from existing lab-made opioids like fentanyl . They include brorphine and U-47700. Researchers first identified brorphine in the unregulated drug supply in 2018. New synthetic opioids may slow breathing, blood pressure, and heart rate to dangerously low levels, potentially contributing to overdose. Emerging opioids can be as powerful or more powerful than fentanyl, which itself is 50 to 100 times more powerful than morphine.
• Synthetic cannabinoids , sometimes called “K2” or “Spice.” Lab-made cannabinoids are chemically similar to the cannabis plant but may have very different effects. Newer synthetic cannabinoids include ADMB-5,Br-BUTINACA and MDMB-4en-PINACA. MDMB-4en-PINACA has been associated with hallucinations, paranoia, and confusion. These substances have been found in people who died from accidental overdose. 9
• Synthetic cathinones , also known as “Bath Salts.” Lab-made cathinones are stimulants that are chemically related to, but not derived from, the khat plant. People sometimes take synthetic cathinones as a less expensive alternative to other stimulants, but cathinones have also been found as an added ingredient in other recreational drugs. Emerging cathinones include eutylone, N,N-dimethylpentylone (dipentylone), and pentylone. These substances have been found in people who died from overdose. 10
• Synthetic benzodiazapines. Benzodiazapenes are a class of lab-made depressants that include prescription medications such as diazepam (sometimes sold as Valium), alprazolam (sometimes sold as Xanax), and clonazepam (sometimes sold as Klonopin). Recent data show that new versions of recreationally manufactured bezodiazapines include bromazolam, disalkylgidazepam, and flubromazepam. 11

How does NIDA support research into emerging drugs?

NIDA supports research tracking the emergence of new drugs into the unregulated drug supply, including via the National Drug Early Warning System (NDEWS) , collaboration with other researchers, partners around the world, and social media. The Institute studies or supports research on changes in the lab-made drug supply and how these emerging substances work in the brain, as well as their health effects and potential as therapeutic treatments.

NIDA also researches ways to prevent substance use and misuse , and studies whether and how harm reduction methods may prevent, reverse, or reduce rates of overdose.

Latest from NIDA

Law enforcement seizures of psilocybin mushrooms rose dramatically between 2017-2022

Can science keep up with designer drugs?

Xylazine appears to worsen the life-threatening effects of opioids in rats

Find more resources on emerging drugs.

• See recent data on Overdose Rates from the Centers for Disease Control and Prevention (CDC). 
• Stay up to date on new and emerging substances at the National Drug Early Warning System website
• Early warning advisory on new psychoactive substances. United Nations Office on Drugs and Crime. Accessed April 15, 2024. https://www.unodc.org/LSS/Page/NPS
• Singh VM, Browne T, Montgomery J. The emerging role of toxic adulterants in street drugs in the US illicit opioid crisis . Public Health Rep . 2020;135(1):6-10. doi:10.1177/0033354919887741
• Gladden RM, Chavez-Gray V, O'Donnell J, Goldberger BA. Notes from the field: overdose deaths involving eutylone (psychoactive bath salts) - United States, 2020 . MMWR Morb Mortal Wkly Rep . 2022;71(32):1032-1034. Published 2022 Aug 12. doi:10.15585/mmwr.mm7132a3
• Pergolizzi J Jr, Raffa R, LeQuang JAK, Breve F, Varrassi G. Old drugs and new challenges: A narrative review of nitazenes . Cureus . 2023;15(6):e40736. Published 2023 Jun 21. doi:10.7759/cureus.40736
• Ujváry I, Christie R, Evans-Brown M, et al. DARK classics in chemical neuroscience: Etonitazene and related benzimidazoles . ACS Chem Neurosci . 2021;12(7):1072-1092. doi:10.1021/acschemneuro.1c00037
• Benzimidazole opioids, other name: nitazenes. Drug Enforcement Agency. Issued January 2024. Accessed April 15, 2024. https://www.deadiversion.usdoj.gov/drug_chem_info/benzimidazole-opioids.pdf
• Papsun DM, Krotulski AJ, Logan BK. Proliferation of novel synthetic opioids in postmortem investigations after core-structure scheduling for fentanyl-related substances . Am J Forensic Med Pathol . 2022;43(4):315-327. doi:10.1097/PAF.0000000000000787
• Trowbridge P, Walley AY. Use of buprenorphine-naloxone in the treatment of tianeptine use disorder . J Addict Med . 2019;13(4):331-333. doi:10.1097/ADM.0000000000000490
• Simon G, Kuzma M, Mayer M, Petrus K, Tóth D. Fatal overdose with the cannabinoid receptor agonists MDMB-4en-PINACA and 4F-ABUTINACA: A case report and review of the literature . Toxics . 2023;11(8):673. Published 2023 Aug 5. doi:10.3390/toxics11080673
• Ehlers PF, Deitche A, Wise LM, et al. Notes from the field: Seizures, hyperthermia, and myocardial injury in three young adults who consumed bromazolam disguised as alprazolam - Chicago, Illinois, February 2023 . MMWR Morb Mortal Wkly Rep . 2024;72(5253):1392-1393. Published 2024 Jan 5. doi:10.15585/mmwr.mm725253a5

Capstone and PICO Project Toolkit

• Starting a Project: Overview
• Developing a Research Question
• Selecting Databases
• Expanding a Search
• Refining/Narrowing a Search
• Saving Searches
• Critical Appraisal & Levels of Evidence
• Citing & Managing References
• Database Tutorials
• Types of Literature Reviews
• Finding Full Text
• Term Glossary

Defining the Question: Foreground & Background Questions

In order to most appropriately choose an information resource and craft a search strategy, it is necessary to consider what  kind  of question you are asking: a specific, narrow "foreground" question, or a broader background question that will help give context to your research?

Foreground Questions

A "foreground" question in health research is one that is relatively specific, and is usually best addressed by locating primary research evidence. 

Using a structured question framework can help you clearly define the concepts or variables that make up the specific research question. 

 Across most frameworks, you’ll often be considering:

• a who (who was studied - a population or sample)
• a what (what was done or examined - an intervention, an exposure, a policy, a program, a phenomenon)
• a how ([how] did the [what] affect the [who] - an outcome, an effect). 

PICO is the most common framework for developing a clinical research question, but multiple question frameworks exist.

PICO (Problem/Population, Intervention, Comparison, Outcome)

Appropriate for : clinical questions, often addressing the effect of an intervention/therapy/treatment

Example : For adolescents with type II diabetes (P) does the use of telehealth consultations (I) compared to in-person consultations  (C) improve blood sugar control  (O)?

Framing Different Types of Clinical Questions with PICO

Different types of clinical questions are suited to different syntaxes and phrasings, but all will clearly define the PICO elements.  The definitions and frames below may be helpful for organizing your question:

Intervention/Therapy

Questions addressing how a clinical issue, illness, or disability is treated.

"In__________________(P), how does__________________(I) compared to_________________(C) affect______________(O)?"

Questions that address the causes or origin of disease, the factors which produce or predispose toward a certain disease or disorder.

"Are_________________(P), who have_________________(I) compared with those without_________________(C) at_________________risk for/of_________________(O) over_________________(T)?" 

Questions addressing the act or process of identifying or determining the nature and cause of a disease or injury through evaluation.

In_________________(P) are/is_________________(I) compared with_________________(C) more accurate in diagnosing_________________(O)?

Prognosis/Prediction:

Questions addressing the prediction of the course of a disease.

In_________________(P), how does_________________(I) compared to_________________ (C) influence_________________(O)?

Questions addressing how one experiences a phenomenon or why we need to approach practice differently.

"How do_________________(P) with_________________(I) perceive_________________(O)?" 

Adapted from: Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

Beyond PICO: Other Types of Question Frameworks

PICO is a useful framework for clinical research questions, but may not be appropriate for all kinds of reviews.  Also consider:

PEO (Population, Exposure, Outcome)

Appropriate for : describing association between particular exposures/risk factors and outcomes

Example : How do  preparation programs (E) influence the development of teaching competence  (O) among novice nurse educators  (P)?

SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research Type)

Appropriate for : questions of experience or perspectives (questions that may be addressed by qualitative or mixed methods research)

Example : What are the experiences and perspectives (E) of  undergraduate nursing students  (S)  in clinical placements within prison healthcare settings (PI)?

SPICE (Setting, Perspective, Intervention/phenomenon of Interest, Comparison, Evaluation)

Appropriate for : evaluating the outcomes of a service, project, or intervention

Example : What are the impacts and best practices for workplace (S) transition support programs (I) for the retention (E) of newly-hired, new graduate nurses (P)?

PCC (Problem/population, Concept, Context)

Appropriate for : broader (scoping) questions

Example : How do nursing schools  (Context) teach, measure, and maintain nursing students ' (P)  technological literacy  (Concept))throughout their educational programs?

Background Questions

To craft a strong and reasonable foreground research question, it is important to have a firm understanding of the concepts of interest.  As such, it is often necessary to ask background questions, which ask for more general, foundational knowledge about a disorder, disease, patient population, policy issue, etc. 

For example, consider the PICO question outlined above:

"For adolescents with type II diabetes does the use of telehealth consultations compared to in-person consultations  improve blood sugar control ?

To best make sense of the literature that might address this PICO question, you would also need a deep understanding of background questions like:

• What are the unique barriers or challenges related to blood sugar management in adolescents with TII diabetes?
• What are the measures of effective blood sugar control?
• What kinds of interventions would fall under the umbrella of 'telehealth'?
• What are the qualitative differences in patient experience in telehealth versus in-person interactions with healthcare providers?
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• URL: https://guides.nyu.edu/pico

Office of Science Policy

Biosafety and Biosecurity Policy

Life sciences research is essential to protecting global health security by helping us to understand the fundamental nature of human-pathogen interactions and informing public health and preparedness efforts, such as the development of vaccines and medical countermeasures. OSP develops policies to preserve the benefits of this research while minimizing its potential misuse.

• Dual Use Research of Concern (DURC)

Research Involving Enhanced Potential Pandemic Pathogens (ePPP)

• NIH Guidelines for Research Involving Recombinant or Synthetic Nucleic Acid Molecules (NIH Guidelines)

Links to Other Biosafety Resources

Faqs and fact sheets.

• IBC Administration
• Externally Administered IBCs
• IBC Meetings and Minutes

Incident Reporting

• Fact Sheet on OSP Review of Requests to Lower the Minimum Required Biosafety Containment Level for Research Subject to the NIH Guidelines
• Interim Laboratory Biosafety Guidance for Research with SARS-CoV-2 and IBC Requirements under the  NIH Guidelines
• Animal Experiments Under the NIH Guidelines
• Animal Activities Table
• Factsheet on Release of Client-Owned Animals After Participation in Research Subject to the NIH Guidelines
• Toxin Experiments
• Major Actions Under the  NIH Guidelines
• Lentiviral Containment Guidance
• Amendments to the NIH Guidelines  Regarding Research Involving Gene Drive Modified Organisms
• Biosafety Considerations for Contained Research Involving Gene Drive Modified Organisms
• April 2019 Amendment of the  NIH Guidelines

Dual Use Research of Concern

Dual Use Research of Concern (DURC) is life sciences research that, based on current understanding, can be reasonably anticipated to provide knowledge, information, products, or technologies that could be directly misapplied to pose a significant threat with broad potential consequences to public health and safety, agricultural crops and other plants, animals, the environment, materiel, or national security. The United States Government’s oversight of DURC is aimed at preserving the benefits of life sciences research while minimizing the risk of misuse of the knowledge, information, products, or technologies provided by such research.

Watch the video “Dual Use Research: A Dialogue”

U.S. Government DURC Policies

• United States Government Policy for Oversight of Life Sciences Dual Use Research of Concern (March 2012)
• United States Government Policy for Institutional Oversight of Life Sciences Dual use Research of Concern (September 2014)
• Companion Guide to U.S. government policies for oversight of DURC

External Resources

S3: Science, Safety, and Security

The U.S. Government and the Department of Health and Human Services define enhanced potential pandemic pathogen (ePPP) research as research that may be reasonably anticipated to create, transfer or use potential pandemic pathogens resulting from the enhancement of a pathogen’s transmissibility and/or virulence in humans.

ePPP research can help us prepare for the next pandemic, for example by informing public health and preparedness efforts including surveillance and the development of vaccines and medical countermeasures. However, such research requires strict oversight and may only be conducted with appropriate biosafety and biosecurity measures.

The HHS  Framework for Guiding Funding Decisions about Proposed Research Involving Enhanced Potential Pandemic Pathogens (HHS P3CO Framework)  was established in 2017 to guide HHS funding decisions on proposed ePPP research and aims to preserve the benefits of life sciences research involving ePPPs while minimizing potential biosafety and biosecurity risks. The HHS P3CO Framework is responsive to and in accordance with the  Recommended Policy Guidance for Departmental Development of Review Mechanisms for Potential Pandemic Pathogen Care and Oversight  issued by the White House Office of Science and Technology Policy following a three-year, public deliberative process .

Department of Health and Human Services P3CO Framework

Department of Health and Human Services Framework for Guiding Funding Decisions about Proposed Research Involving Enhanced Potential Pandemic Pathogens

U.S. Government Policy on Enhanced PPP Research

Recommended Policy Guidance for Departmental Development of Review Mechanisms for Potential Pandemic Pathogen Care and Oversight

Potential Pandemic Pathogen Care and Oversight (P3CO) Policy Development

NSABB Recommendations for the Evaluation and Oversight of Proposed Gain-of-Function Research

U.S. Government Gain-of-Function Deliberative Process and Research Funding Pause on Selected Gain-of-Function Research Involving Influenza, MERS, and SARS Viruses

FAQs on the U.S. government Gain-of-function Deliberative Process and Research Funding Pause

Symposia Summaries and Commissioned Reports

1st National Academies Symposium Summary (December 15-16, 2014) – Potential Risks and Benefits of Gain-of-Function Research: Summary of a Workshop

2nd National Academies Symposium Summary (March 10-11, 2016) – Gain-of-Function Research: Summary of the Second Symposium

Risk and Benefit Analysis of Gain of Function Research – Final Report  (Gryphon Scientific)

Gain-of-Function Research: Ethical Analysis  (Professor Michael J. Selgelid)

Additional Material

NIH Director’s Statement on Funding Pause on Certain Types of Gain-of-Function Research

NIH Director’s Statement on Lifting of NIH Funding Pause on Gain-of-Function Research

NIH Director’s Statement on NIH’s commitment to transparency on research involving potential pandemic pathogens

Supplemental Information on the Risk and Benefit Analysis of Gain-of-Function Research

Gain-of-Function Deliberative Process Written Public Comments (Nov 10, 2014 – June 8, 2016)

NIH Guidelines for Research Involving Recombinant or Synthetic Nucleic Acid Molecules (NIH Guidelines )

• NIH Guidelines – April 2024 (PDF) (Printer friendly for duplex printing)
• Federal Register Notice – April 2024

The NIH Guidelines require that any significant problems, violations, or any significant research-related accidents and illnesses” be reported to OSP within 30 days. Appendix G of the NIH Guidelines specifies certain types of accidents that must be reported on a more expedited basis. Specifically, Appendix G-II-B-2-k requires that spills and accidents in BL2 laboratories resulting in an overt exposure must be immediately reported to the OSP (as well as the IBC). In addition, Appendices G-II-C-2-q and G-II-D-2-k require that spills or accidents occurring in high containment (BL3 or BL4) laboratories resulting in an overt or potential exposure must be immediately reported to OSP (as well as the IBC and BSO).

• Incident Reporting FAQs – December 2023
• Incident Reporting Template – April 2019

*Incident reports may be released to the public in full. Please note that incident reports should not include personally identifiable information or any information that you do not wish to make public. Proprietary, classified, confidential, or sensitive information should not be included in the report.  If it is necessary to include such information, please clearly mark it as such so that it can be considered for redaction in accordance with Freedom of Information Act exemptions.*

IBC RMS and Registration Information

• Institutional Biosafety Committee Registration Management System (IBC-RMS)

IBC Self-Assessment Tool

• IBC Self-Assessment Tool – April 2024

Investigator Brochure

• Investigator Responsibilities under the  NIH Guidelines for Research Involving Recombinant or Synthetic Nucleic Acid Molecules  – October 2021

Additional Resources

• CDC Biosafety Resources and Tools
• American Biological Safety Association (ABSA)
• AIHA Home Page
• American Society for Microbiology
• The American Society of Gene and Cell Therapy
• Association for Assessment and Accreditation of Laboratory Animal Care (AAALAC) Website
• The Centers for Disease Control and Prevention (CDC) Website
• The US Department of Health and Human Services (HHS)
• The Office for Human Research Protections (OHRP)
• The Federal Register Website
• The Office of Laboratory Animal Welfare
• The Animal and Plant Health Inspection Service (APHIS) Website
• Biosafety in Microbiological and Biomedical Laboratories (BMBL)
• Risk Group Classification for Infectious Agents (ABSA)
• Select Agent Program
• Association for the Accreditation of Human Research Protection Programs
• Biosafety Discussion List