How to come up with Research Questions and Quality improvement projects?

Jitender Sareen MDProfessor of Psychiatry, Psychology, Community Health Sciences

University of Manitoba

ACKNOWLEDGEMENTS

• Canadian Institutes of Health Research• Research Manitoba• Co-investigators, mentors, students,

patients• Family

Moving research forward

How to come up with research and QI ideas?

• Listen• Observe• Be Curious• Ask questions• Problem Solve• Make Connections

Quiz- from Dr. Olafson’s talk

• What is the difference between a Research project and a Quality improvement project?

Research vs. QI

• Research Project:– Creation of new knowledge.

• Quality improvement project– Translate established knowledge into improving

care locally.

What types of research and quality improvement questionscan you ask around a case?

• 26 year old veteran of Afghanistan, multiple concussions, leaving military, multiple relationships, presenting to clinic with back pain, posttraumatic stress disorder, wanting medical marijuana for treatment.

Read around the case!

• What should you read?– Practice guidelines– Systematic reviews and meta analyses– Read once a week the abstract from the highest

impact journals in your field.– You will be surprised how relevant the articles are to

your clinical cases.– Go to conferences and actually attend the talks not

just go to the beach!– TED talks!

When reading

• Ask yourself:– What is known about this topic?

– What is not known?

• Next compare what is recommended as treatments to what is being practiced….

How do you get an idea?

• Listen• Observe• Be curious• Ask questions• Problem solve• Make Connections

Keys to success: TED talkRichard St. John – 8 Secrets of Success

1. Ideas2. Passion3. Hard work4. Good – practice, practice, practice5. Focus on the task6. Push through self-doubt and shyness7. Serve- serve others something of value…

8. *** Persist***

• Persist through CRAP• Criticism• Rejection• Assholes• Pressure

Categories of Questions I

• Epidemiology– Seems boring but kind of important– How common is it?– What is the natural history of the condition with

and without treatment?– What is the impact on the person, family and

system?– How many people get treatment/need treatment?

Categories of Questions II

• Differential diagnosis/Diagnostic classification/comorbidity

• What are the common comorbid conditions?• How should we classify the disease?– EG. PTSD is NOT an anxiety disorder anymore– EG. Depression with psychosis

Categories of Questions III

• What is the cause of the illness?– Although in papers, we are careful about not making causal

statement, everyone wants to know why did this person present with these symptoms, at this particular time?

• The short answer is we often don’t know.

• Important to use Biopsychosociocultural approach to understanding disease

Categories of Questions IV

• Prevention studies– Eg. Suicide prevention, ptsd prevention…

• Treatment studies– Biological treatments– Psychosocial treatments

Categories of Questions

• Range of medical education questions…• W. Fleisher…

How to come up with research and QI ideas?

• Listen• Observe• Be Curious• Ask questions• Problem Solve• Make Connections