Tutorials in clinical research: Part III. Selecting a research approach tobest answer a clinical question

Objective: This is the third in a series of sequential "Tutorials in Clinic al Research,"(1,2) The objectives of this specific report are to enable the reader to rapidly dissect a clinical question or article to efficiently de termine what critical mass of information is required to answer the questio n and what study design is likely to produce the answer, Study Design: Tuto rial. Methods: The authors met weekly for 3 months exploring clinical probl ems and systematically recording the logic and procedural pathways from mul tiple clinical questions to the selection of proper research approaches. Th e basic elements required to understand the processes of selection were cat alogued and field tested, and a report was produced to define and explain t hese elements. Results: Fundamental to a research approach is the assembly of subjects and the allocation of exposures. An algorithm leading to the se lection of an approach is presented. The report is organized into three par ts. The tables serve as a rapid reference section. The initial two-part nar rative explains the process of approach selection. The examples section ill ustrates the application of the selection algorithm. Conclusions: Selecting the proper research approach has six steps: the question, logic and ethics , identification of variables, data display considerations, original data s ource considerations, and selection of prototypical approaches for assembly of subjects. Field tests of this approach consistently demonstrated its ut ility.