Editorial -Research! Research! Research! What are Thou?

• Main Author: Ashok Shyam
• Format: Article
• Language: English
• Published: Indian Orthopaedic Research Group 2013-04-01
• Series: Journal of Orthopaedic Case Reports
• Online Access: http://www.jocr.co.in/wp/2013/07/01/2250-0685-104-fulltext/

Being in field of Orthopaedic research since last 6 years, I have personally been witness to the rapid change in landscape of Othopaedic Research and also medical research in general. The sheer volumes of publications is overwhelming to the extent of being mostly ineffective in providing significant positive addition to the current literature. “There are too many variables” is one of my favorite phrase when I start to explain something to myself. Looking at as many variables as we can think of, makes us understand concepts within the limitations of given variables. Something similar to Ashby’s law that we spoke about in last Editorial [1]. However when we try to apply this to word ‘Research’ the amount of subjective stereotype that is associated with the word defeats all attempt to decipher and communicate clearly. Originally word Research derived from French ‘Researche’ simply means ‘Pursuit of Knowledge’. We as medical practitioners in search of better treatment for our patients are always in pursuit of knowledge. This knowledge is mostly build individually and is learned from individual experience and learning. This is a subjective body of knowledge and this is what makes one surgeon better than another. But is this ‘Research’? Yes it is Research and it serves the main purpose of medical research that is to improve the treatment given to patients. However this is a limited form of research, limited by individual’s ability and capacity. It also does not subject itself to rigorous ‘scientific methods’ and may not be acceptable to a community of ‘Modern Researchers’. Another form of Research of pursuit of knowledge is again from the clinics and from reading journals and books. A collaboration of clinical experience and written word adds a more thoughtful way of pursuing knowledge. This I think is the way majority of medical practitioners acquire knowledge. This keeps them updated and also helps them provide good care to their patients. The third form is where Modern Research tools are used and studies are designed to answer clinical questions. A subset of this is Evidence based Medicine. This is currently the most favored kind of research as it apparently allows a proper organization of data and generation of high quality knowledge (although this quality may not have anything to do with impact on patient treatment or clinical decision making). Now we are talking in a very limited terms looking at a very small part of research namely ‘Clinical Research’. Which of the three forms is more accurate or more vital when decisions are made in terms of treating individual patients? Probably all three are equally important but what varies is subjective importance that each of us put on these concepts. Creating a hierarchy of these does not seem to be a very smart move rather than an amalgamation of all these complimentary form of ‘researchre’ should be the aim. Finding a way to scientifically stich together all these forms of research is a challenging task but will be very valuable. Although a variety of faces of research exist from Personal, subjective and objective statistical, I believe the clinical decision making lies somewhere in the middle of this spectrum and a proper analysis of this framework is needed to make use of positives aspect of both the ends of the spectrum.