A predictable pattern in research efforts is seen in 28 academic centers in physical medicine and rehabilitation. They consist of at least one technician and one small research room (220 square feet), with an additional small room (280 square feet), and 1/4 technician for every MD or PhD in the department (r=0.72). Persons who are not active researchers with external funding must first define the research question in order to develop fundable research proposals. Clinical research is a process that starts from the clinical situation, leads to formulation and answering of the question, and eventually results in integration back into clinical practice. There are many reasons for posing a clinical research question and each results in a different type of question. Asking the right question is the most important part of research, as how the problem is stated determines what data is to be collected, the analysis to be done, and what kind of conclusions can be drawn. A strong research study addresses questions that are clearly spelled out and leads to conclusions that are within the limits of the experimental design and the availability, reliability, and validity of the data. Complex design and analysis do not make a study better if the question itself is not well formulated. It is not as important to know how to answer the question as it is to know how to ask the question. If the initial question is incomplete or incorrect, the rest of the research is at best irrelevant. If the type of question (descriptive, normative, or cause and effect) and the desired use of the research (generalized or not) are identified for each potential research question, one can begin to decide which questions are feasible to answer, given available resources. The resources available that must be considered in selecting the question include time, cost, staff expertise, facilities, and potential subjects. The research format includes not only the questions, but also the methods employed to answer those questions, a data collection plan, and an analysis plan. Posing these in advance, in addition to being good research, substantially reduces costs by decreasing unnecessary data collection and analysis and decreasing the time necessary to complete the project. Exercises and readings are provided to assist development of the entire research format.
