Flowchart
NIHR RDINFO – Research Process Flowchart for Conducting Research In England - Turn your idea into a research question

This flowchart is for research conducted in England. 
If your research is collaborative between Wales, Scotland, Northern Ireland or other countries
you must take into account and follow procedures for each of these countries.

1. Turn your idea into a research question

First stages

Where do you start?

  • Decide on a general area of interest
  • Why does this area interest you?
  • Answer the questions:
    • What is your aim? (In general terms)
      • Are you looking to test a hypothesis? (see section 8 on data analysis)
        • If yes, clearly state your hypothesis in the form of an answerable question or series of answerable questions
        • If no, what are you trying to do?
          • Explore a new area to get basic understanding of something we currently have little knowledge of?
          • Explore an area in which we do have knowledge but in a new/novel way?
          • Explore the relationship between two phenomena for the first time?
      • Is your idea novel? (See Section 2 on reviewing the literature)
      • Why does it matter?
      • How will NHS patients or service users benefit form your research? Consult colleagues and other researchers

    Discuss your ideas with others

    User Involvement

    Involve users at all stages of the research process (See User Involvement section) especially:

    • Setting the research agenda (See Section 2 of this flowchart)
    • Developing the proposal (See Section 3 of this flowchart)
    • During the conduct of the project
    • Disseminating results (See Section 10 of this flowchart)

    Other issues to consider

    • Collaborating with experienced researchers (See Section 3 of this flowchart)
    • Having your research proposal peer reviewed at every stage. (See Section 4 of this flowchart)
                    
NIHR RDInfo - Research Process Flowchart - Review the Literature

2. Review the Literature

  • It is essential that existing sources of evidence, especially systematic reviews, are considered carefully prior to undertaking research.
  • Re-inventing the wheel? Research which duplicates other work unnecessarily or which is not of sufficient quality to contribute something useful to existing knowledge is in itself unethical.

Where do I start?

Libraries

Libraries are a very good source of information and help.

Links to useful websites

These websites are excellent for literature searching. In some cases you will need a password which your library may be able to provide.

  • PubMed -Searches MEDLINE and other life science journals for biomedical articles back to the 1950s
  • Intute - Major bibliographic database for biomedical sciences
  • Cochrane Library - A collection of evidence-based medicine databases, including The Cochrane Database of Systematic Reviews
  • Embase - Major bibliographic database for biomedical sciences
  • PsycINFO - Major bibliographic database for psychology. Coverage: 1887 to date.
  • RDDirect - for links to the above and to other databases
  • NHS Evidence provides access to 8 bibliographical databases and over 800 full text journals. You will need an Athens username/password to gain access, so contact your library for details. The databases, which are excellent for literature searching are:
    • AMED - Allied and Complementary Medicine Database
    • BNI - The British Nursing Index (BNI) is a UK nursing database which covers British publications and other English language titles from over 220 related journals.
    • CINAHL - Major bibliographic database for nursing and allied health
    • DH-DATA - jointly produced by two services at the Department of Health (UK): The Department of Health Library and Information Service and Solutions for Public Health. The core subjects covered by the Department of Health Library are health service and hospital administration, with an emphasis on the British National Health Service. Solutions for Public Health specialises in medical toxicology and environmental health.
    • EMBASE - Major bibliographic database for biomedical sciences
    • KING'S FUND - Focus on improving health and health care, covering policy and management of health and social care services in the UK rather than clinical issues and treatments. Core subjects include National Health Service (NHS) management, social care, health inequalities, urban health and regeneration, race and health, partnership working, primary care, mental health, public involvement, and workforce development in the NHS.
    • MEDLINE - Major bibliographic database for biomedical sciences
    • PSYCHINFO - Major bibliographic database for psychology.
    • PubMed - Access is freely available and does not require a special password to access.

Systematic Reviews

The NHS Centre for Reviews and Dissemination at The University of York has published an excellent guide on systematic reviews.

RDInfo Flowchart - Design the Study and Develop Methods

3. Design the Study and Develop Methods

Participant Involvement

Consider the effect of your research on the participant.

  • Does the design methodologies pose practical or even ethical problems for those taking part?
  • Engage with users whilst designing your study to ensure your study works well in the real world. Engagement should
    • Be as early as possible in the process
    • Could be in the form of a small focus group, users on your study design team or speaking to a relevant patient support or other group.
  • UK Clinical Research Networks often have access to local and national user involvement groups and may be able to help .
  • User Involvement section

Survey Design

Do you know what is the most appropriate survey method for your research project? What method will give you the most useful data for the project you are working on? The Research Methods Knowledge Base has many useful sections on social research methods including:

Sampling

What method of sampling will give you the most useful data for the project you are working on?

Statistical Issues

Are you familiar with the statistics you may need to use? If not, consider enrolling on a suitable course. RDLearning, your local RDS, R&D Office or Higher Education Institution should be able to assist you in finding a relevant course. Other tools and guidance:

Qualitative and Quantitative Research Methods

Which research method is most appropriate to your research project? Do you know the difference between quantitative and qualitative research methods?

NIHR RDInfo - Research Process Flowchart - Writing your research proposal

4. Writing your research proposal

Starting your research proposal

  • First talk about your research proposal with your supervisor. Your supervisor will advise you on writing your research proposal .
  • Consider how you get input from users in the development process (see section 3) and ideally have several involved throughout the development process
  • You should contact your proposed sponsor and discuss your proposal.
  • The researcher has a responsibility for developing proposals that are scientifically sound and ethical.
  • No two proposals are the same, but they will all have a similar structure:
    • title
    • abstract/summary
    • background or rationale of the project
    • aims/objectives
    • experimental design and methods
    • ethical considerations
    • benefits of the study
    • resources and costs
    (Adapted from material by Keith Chantler, R&D Manager, Central Manchester and Manchester Children's Hospitals)
  • Key elements in a research proposal (from Hull & East Yorkshire Hospitals NHS Trust R&D Resource pack)
  • Use the following to check if you have included everything you need in your research proposal:
    'Writing a research proposal: some thoughts to consider'
  • Specimen online application forms for grants/awards can be viewed on RDFunding
  • Guidelines have been developed providing recommendations for reporting various types of research studies. These specify a minimum set of items necessary for a clear and complete accounting of what was actually done. We recommend you consult a relevant guideline in the early stages of research planning. Visit EQUATOR Network  to find a relevant guideline.
  • When writing a proposal it is important to consider who will be reviewing it (e.g. for funding and/or peer review),as often it will be scrutinised by lay members of committees. The following offers advice on writing clearly & effectively

Peer Review

Sponsor Issues

The Research Governance Framework for Health and Social Care for the NHS made clear that no research with human participants, their organs, tissue or data, may begin or continue in the NHS until a sponsor accepts responsibility.

  • The designation 'sponsor' describes a set of functions for which one of the lead organisation takes on the responsibility. It will normally be one of the following:
    • the lead health or social care organisation,
    • the lead employer of the researchers, or
    • the main funder.
  • The sponsor needs to be involved in finalising your protocol to ensure any of their standard systems and templates are built into the study.
  • The sponsor must be satisfied that clear agreements are reached, documented and carried out, providing for proper initiation, management, monitoring and financing.
  • A list of recognised sponsors was on the DH website. With the expected implementation of Directive 2001/20/EC, organisations on the list are being given the opportunity to reconsider their position in the light of the Directive's requirements. The list of sponsors will now be reconstituted, and a link will be provided to the updated document when available. 

Further Help

  • Speak with your supervisor or mentor
  • Contact RDLearning for courses and workshops for additional skills and knowledge about writing research proposals
  • Contact RDDirect for further advice: telephone 0113 295 1122 or email info@rddirect.org.uk
NIHR RDInfo - Research Process Flowchart - Issues About Funding

5. Issues About Funding

Advice About Funding

Do you need any advice concerning funding for your research project?

  • Visit RDFunding for database of funding opportunities health and social care
  • Contact RDDirect for further advice on 0113 295 1122 or email them
  • Contact your local R&D Department, your local RDS or relevant research lead to discuss issues about funding
  • To find our more about current research projects, and the funding they have received visit the NIHR CRNCC Portfolio Database. Details of past projects can be found in the archive of e National Research Register (NRR)
  • Visit RDDirect for links to other database of research projects
  • Most large funders require genuine user involvement in applications, so make sure you take this into account

Project Planning

You should have a plan containing

  • a rationale
  • a strategy (including objectives, timescales and milestones, and methodology) and
  • an estimate of resources.

The plan should demonstrate that an assessment has been made of the key factors that will influence the success of the project in terms of achieving its objectives including:

  • collection of an adequate amount of data or information
  • its proper statistical analysis

NHS R&D costs

You need to consider the financial implications for the NHS of the research you are thinking about doing, and be clear when you apply for research funding what is and what is not a research cost. The document Attributing revenue costs of externally-funded non-commercial research in the NHS (ARCO) from the Department of Health clarifies this.

Sponsor costs

You must contact your sponsor before finalising your proposal and applying for funding to ensure any related costs are in included in the application.

Costings Checklist

Have you thoroughly assessed the potential costs of your research project? Allow sufficient time for the costings to be verified by the host institution finance office.

Salaries

Will you need to pay for any other assistance or do you have enough staff within your research project?

Paying Consumers Involved in Research

There can be difficulties in paying users to be involved in your research, especially for those receiving state benefits.

  • More guidance is published by INVOLVE

It is important to cost for the involvement of users in development and management of the study, as well as disseminating results to them after it has finished.

NIHR RDInfo - Research Process Flowchart - Ethical and Trust approval

6. Obtain Ethical and Trust approval?

All projects need to be reviewed by a research ethics committee and you must get permission from all NHS organisations where you will be conducting your research.

Do you know where to start and what to consider in relation to ethics in your research project? The National Research Ethics Service (NRES) has a section on Do you need ethical approval? included with other frequently asked questions.

Applying to a Research Ethics Committee

Research Ethics Committees (RECs) have been working to standard operating procedures since 1st March 2004. NRES gives people access to comprehensive and up-to-date information on the REC system in the UK including Guidance for applicants.

The new Integrated Research Application System (IRAS) is now in use.

Applying to NHS Organisations for R&D Approval

The NHS R&D Forum provides guidance to applying for R&D approval from the NHS.

The SSI form needs to be completed for all studies taking place in the NHS. This form is incorporated into the IRAS.

Your R&D Department and RDDirect may be able to help you with the application process.

Prepare your information sheet and consent form

This is one area where as a researcher you will get extra benefits from including patients/carers in your research project.  By including patients in the project from the early stages the project team will be in a position to develop forms specifically for the project that also have appropriate language and have been looked at from the perspective of a potential participant.  Often the difficulty comes from producing forms that use lay language but still provide the right information for the project.

How do you fill out ethical consent forms?

Ensure your participant information meets the needs of those using it:

Research Governance

What is research governance? How does it affect me?

NIHR RDInfo - Research Process Flowchart - Collect and collate the data

7. Collect and collate the data

Issues to consider

  • Beware of biases: yours and/or other researchers'
  • Seek statistical advice if necessary

Conduct Issues

  • Researchers bear the day-to-day responsibility for the conduct of research in terms of:
    • Ensuring that research follows the agreed protocol (or proposal).
    • Making sure that participants receive appropriate care while involved in research.
    • Protecting the integrity and confidentiality of clinical and other records and data generated by the research.
    • Reporting any failures in these respects, any adverse drug reactions and other events or suspected misconduct through the appropriate systems.
  • Data collected in the course of research must be retained for an appropriate period to allow further analysis by the original or other research teams subject to consent, and to support monitoring of good research practice by regulatory and other authorities.
  • When conducting your research take steps to seek feedback from your participants. This will help you overcome practical problems you could not have foreseen and will help to ensure your project runs well and meets its objectives.

Data Protection and Confidentiality

  • Data Protection Act stipulates that the appropriate use and protection of patient data is paramount in the research setting.
  • All those involved in research must be aware of their legal and ethical duties, particularly in terms of ensuring confidentiality of personal information about living or deceased participants.
  • When collecting and storing data on human participants, the following should be considered:
    • Identities should be disguised by use of codes (do not use initials!)
    • Any details should be anonymised
    • Use of patient-identifiable information should be avoided unless absolutely necessary
    • If unavoidable, only minimum necessary patient-identifiable information should be used
    • Access to patient-identifiable information should be on a strict need to know basis.
    • Keeping and Archiving data guidelines from the Department of Health

More information can be found on Department of Health Data Protection page and in the document  Confidentiality - NHS Code of Practice.  

Further help

Suggested Reading

  • A reading list provided by The University of Leeds' School of Medicine's Health Research course MEDR 5110 Module 3: Handling Data for Research provides information about books useful to the researcher when collecting and handling data.
NIHR RDInfo - Research Process Flowchart - Analyse the data and interpret findings

8. Analyse the data and interpret findings

Quantitative Data Analysis

  • Quantitative research techniques generate a mass of numbers that need to be summarised, described and analysed.
  • Characteristics of the data may be described and explored by drawing graphs and charts, doing cross tabulations and calculating means and standard deviations.
  • Further analysis will build on these initial findings, seeking patterns and relationships in the data by comparing means, exploring correlations, performing multiple regressions, or analyses of variance.
  • Advanced modelling techniques may eventually be used to build sophisticated explanations of how the data addresses the original question.
  • Although methods used can vary greatly, the following steps are common in quantitative data analysis:
    • Identifying a data entry and analysis manager (e.g., SPSS)
    • Reviewing data (e.g., surveys, questionnaires etc) for completeness
    • Coding data
    • Conducting Data Entry
    • Analysing Data (e.g., sample descriptives, other statistical tests).

Qualitative Data Analysis

  • Qualitative data analysis describes and summarises the mass of words generated by interviews or observational data.
  • It allows researchers to seek relationships between various themes that have been identified or relate behaviour or ideas to biographical characteristics of respondents.
  • Implications for policy or practice may be derived from the data, or interpretation sought of puzzling findings from previous studies.
  • Ultimately theory could be developed and tested using advanced analytical techniques.
  • Although methods of analysis can vary greatly (e.g., Grounded Theory, Discourse Analysis ) the following steps are typical for qualitative data analysis:
    • Familiarisation with the data through repeated reading, listening etc.
    • Transcription of interview etc. material.
    • Organisation and indexing of data for easy retrieval and identification (e.g. by hand or computerized programmes such as Nvivo -formally NUD*IST)
    • Anonymising of sensitive data.
    • Coding (may be called indexing).
    • Identification of themes.
    • Development of provisional categories.
    • Exploration of relationships between categories.
    • Refinement of themes and categories.
    • Development of theory and incorporation of pre-existing knowledge.
  • For more information see 'Qualitative Research' from East Midlands RDS.

Interpreting Data

  • Visit RDDirect for a list of websites containing relevant information on statistics
  • The last step of data analysis consists of interpreting the findings to see whether they support your initial study hypotheses, theory or research questions.
  • Data interpretation methods vary greatly depending on the theoretical focus (i.e., Qualitative or Quantitative research) and methods (e.g., Multiple Regression, Grounded Theory).
  • You should seek further advice for this step from:
    • Your supervisor/Other experts within your organization
    • Computer Package Manuals (e.g., SPSS, Nvivo) and methodology books
    • Statistics in Research from East Midlands RDS
    • The material in Section 3 of this flowchart on statistics and sampling issues
    • The panel of advisors at RDDirect tel. 0113 295 11 22 (e-mail).

Suggested Reading

  • Books on data analysis and interpretation from the reading list from the University of Leeds' School of Medicine's Health Research course MEDR 5120 Module 5: Analytic Research
RDInfo Flowchart - Implications of your research for clinical practice

9. Implications of your research for clinical practice and identifying how findings could be put into practice

Evidence-Based Practice

  • Evidence-Based Medicine; How to Practice and Teach EBM - David L. Sackett, Sharon E. Straus, W. Scott Richardson, William Rosenberg, R. Brian Haynes
    This book is a very useful resource, and will be available in most university and hospital libraries. An accompanying CD provides clinical examples from other disciplines, and information about resources to support evidence-based decisions.Look in particular at Chapter 1: 'Asking Answerable Clinical Questions', and Chapter 2: 'How to Find Current Best Evidence'. Also visit their website.
  • University of Sheffield: the ScHARR Core Library for evidence-based practice is a virtual library of links to full text documents on all aspects of evidence-based practice

Research evidence

Commercial Aspects/By-products of Research

  • Some advances in health and social care need to be developed commercially if they are to be made widely available, such as:
    • Drugs,
    • Medical devices and
    • Aids for disabled people
  • Successful commercial development often depends upon the protection of intellectual property or commercial confidentiality at critical points in the innovation process.
  • The Policy Framework for the Management of Intellectual Property within the NHS issued by the Department of Health provides guidance on Intellectual Property.
RDInfo Flowchart - Report on the Study and Disseminate Findings

10. Report on the Study and Disseminate Findings

What's the next step after the data has been collected, analysed and interpreted?

Writing up Research

What do you need to consider when writing up your research? In what style will you write up research? It is important to remember to disseminate your findings outside of academia and to those who have participated or who may benefit from your research (See section below.)

  • A research report is a carefully structured piece that clearly states the purpose, findings and relevance of research activity.
  • A report may be written for a range of reasons and for a variety of audiences, therefore its length, style and detail tend to vary greatly.
  • Research reports are usually produced for such groups as service users, multi-disciplinary colleagues, and fellow professionals and as a result of commissioned research.
  • The publication Presenting and Disseminating Research by Jane Schober and Andy Farrington for East Midlands RDS, contains comprehensive information on the following topics:
    • First section: "Writing up a Research Project" includes:
      • The research report
      • The research dissertation
      • Common features of research reports and dissertations
    • Second Section: "Contents of a written report" includes:
      • Layout
      • Specific guidelines on dissertations by literature review
      • Producing a short report or executive summary from a main study
  • For those completing a thesis,Writing and Presenting Your Thesis or Dissertation by S. Joseph Levine, Michigan State University, covers important aspects of academic writing. (NOTE: Please check with your own institution for specific requirements.)
  • For more general tips on writing academic papers, we recommend the following:
    • Effective Writing taken from a PowerPoint presentation on Writing for Publication produced by the University of Loughborough.
    • Writing Academic Papers by Rob Newell, Professor of Nursing Research, the University of Bradford.

Research Reporting Guidelines

A large number of guidelines providing recommendations for reporting various types of research studies have been developed. The guidelines specify a minimum set of items necessary for a clear and complete accounting of what was actually done. Visit the EQUATOR Network  to find a relevant guideline.

Disseminating Research

Are you writing up your research for publication? Have you chosen how and where to publish your results?

  • A PowerPoint presentation written by Theo Raynor and Jonathan Silcock, School of Healthcare Studies, University of Leeds. This presentation is excellent and a very comprehensive guide.
  • Further extracts taken from the publication Presenting and Disseminating Research by Jane Schober and Andy Farrington for East Midlands RDS, provide information in the section 'Dissemination research outcomes' on the following topics:
    • Strategies for local, national and international dissemination of research
    • Publication
    • Tips on getting published
  • The Writing/Publishing Research section of the RDDirect web site also offers links to further information on aspects of submitting articles for publication in medical journals.

Presentation for Conferences or Seminars

Are you presenting your research findings to an audience? If so, what kind of audience?

  • RDLearning has a list of potentially relevant conferences and seminars
  • Reporting Scientific Data contains information on producing posters and making oral presentations
  • Section "Dissemination research outcomes" in Presenting and Disseminating Research by Jane Schober and Andy Farrington for East Midlands RDS, provide information on the following topics:
    • Types of presentation
    • Tips on presenting at a conference
    • The abstract and usual abstract guidelines
  • For more general tips on Powerpoint presentations, we recommend Creating an Effective PowerPoint Presentation compiled by Thomas Saylor PhD, Concordia University, Minnesota.

Making your findings known to users

  • Health and social care research is conducted for the benefit of patients, users, care professionals, and the public in general. Researchers should publish and disseminate their findings outside of the academic arena.
  • There should be free access to information both on the research being conducted and on the findings of the research, once these have been subjected to appropriate scientific review through the accepted scientific and professional channels:
    • It is good practice to inform the participants of your research and other interested parties (e.g. patient support groups) of your results once the study has finished AND
    • Results must also be made available to all those who could benefit from them (e.g., patients, care professionals, the general public)

This could be done via a newsletter or flyer or by posting information in layman’s language on websites that are accessible to the public. It is vital that you budget for this activity in your funding.