Читать книгу How to Succeed in Medical Research - Robert Foley Andrew - Страница 20

Original research is arguably the most important type of research to perform and should be the goal. The first step in original research will be to identify an interesting clinical question and then design a study to attempt to answer the question. For example, if we consider migraine‐type headache, we could ask: what is the relationship between patients' migraine headache and patient clinical features? Are there any risk factors that predispose patients to migraine headache, such as age or weight? We can then look at a group of patients with migraine and a group of patients without migraine and compare the findings in both groups. This would be termed a ‘case–control study’. These sorts of studies are retrospective in design and look back at risk factors in patients with a defined outcome (i.e. a diagnosis of migraine headache or not). Case–control studies can be an excellent starting point for original research because they are cheap and easy to perform.

In contrast to this, cohort studies look at a population of patients and compare those who were exposed to something and those that were not and then see what the outcomes are in each group. A classic example of this type of research is the Framingham Heart Study [5], which began in the 1940s. This study followed large numbers of patients from the beginning of the study and waited to see which patients developed heart disease. The researchers then looked back at the clinical features that differed between those patients who developed heart disease and those patients who did not. This study found correlations between heart disease and risk factors such as smoking, high cholesterol, and high blood pressure. The disadvantage of this type of study is that it requires large amounts of funding and takes a long time to conduct. Therefore, although this type of research can be very valuable, it is not the ideal place to start.