Medical research is an essential tool to the study and practice of medical knowledge. The field of medicine is largely experimental; it is a dynamic field that is in constant need of review and refinement, and that is where medical research plays its role. By collecting and analyzing the data of patients presenting with certain illnesses, standard treatments can be reevaluated for their capabilities of producing better results, and new treatments can be investigated for their efficacy in improving patient care. At the Kings County (KCH) and University Hospitals of Brooklyn (UHB), New York, medical research is an integral part of the daily programs of these two health centers, and I was fortunate to have the opportunity to participate as a research associate in a few of the studies being conducted.
The role I and a number of other undergraduate and medical students played in the research process lays in the early stages of any research protocol, the identification of emergency room patients who fit the criteria of a particular study, followed by careful collection of relevant data from the patients’ hospital records. Although a relatively simple role, the precise collection of data is crucial to the analysis of it, as well as to the formulation of meaningful conclusions based on this data.
The main data collections conducted during my time at the hospitals, about one year, were for general patient admissions to the critical care and trauma centers of both hospitals. By collecting specified information about the various patients who come in to the emergency room from day to day, the research associates are helping to build the hospital’s databases for these patients. Although no specific study has been laid out for the collection of this data, much of the hospital’s research focuses on critical care and trauma patients, and having a large amount of these types of patients’ data accessible to a researcher is valuable in the identification of certain trends typical to specific conditions, as well as to increasing the sample size of subjects used in a study. The randomization of data collections was also achieved by having a good number of research associates present at various shifts, so as to have a representative sample of the types of patients who come in to the ER on different days of the week and at different times of day.
The downside to the method of data collection used is that, because it was being collected without a specific goal in mind, important factors necessary to answer a research question may be missed if not recorded at the time the patient came in, and it would be almost impossible to track them down for the information at a later time. One way by which this aspect may be corrected is for the research heads of this data collection to periodically analyze the pooled data, determine any trends that should be looked out for in the future, and add or remove data entries appropriately. Also, because research associates come in at their own convenience, the selection of patients to enter into the database is not completely random; some time slots will be entirely left out.
There were a few data entries we were asked specifically to report for critical care and trauma patients, values that did have a particular purpose. For example, along with the standard array of chemistry values reported for each patient, we were required to request that values for blood magnesium and phosphate also be evaluated. These lab values, as well as some of the routinely collected ion values, will be used to calculate a parameter called the strong ion gap. This is a value solved for by an equation that calculates the difference between the concentrations of positive and negative ions in the blood stream, and this result will be analyzed to determine if its value is predictive of the prognosis of a critically ill patient. For trauma patients, the same parameter will be calculated, with the addition of a lactate value, which is why we were also required to inquire about it for trauma patients.
Working as a research associate has been a very informative and enriching experience. It has given me a taste of what hard work, determination, and fine details are involved in the mind-boggling complexity of today’s medical technology, as well as an appreciation and gratitude for how much humans have progressed in the field of medicine, and finally, a realization that there is still so much to research and discover.
Although the collection of studies conducted at KCH and UHB are very different from each other, they all share the same purpose: they are set out to answer important clinical questions that could have drastic effects on patient care, and in some cases, on saving people’s lives. It is the little questions that medical research studies like the ones described above are out to answer that makes this field so valuable, for each little question gives a little answer, and each little answer adds to the big picture of human health and the maintenance of life to its greatest quality and capacity.