what is a research hypothesis in an observational study

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• v.36(50); 2021 Dec 27

Formulating Hypotheses for Different Study Designs

Durga prasanna misra.

1 Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Armen Yuri Gasparyan

2 Departments of Rheumatology and Research and Development, Dudley Group NHS Foundation Trust (Teaching Trust of the University of Birmingham, UK), Russells Hall Hospital, Dudley, UK.

Olena Zimba

3 Department of Internal Medicine #2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.

Marlen Yessirkepov

4 Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan.

Vikas Agarwal

George d. kitas.

5 Centre for Epidemiology versus Arthritis, University of Manchester, Manchester, UK.

Generating a testable working hypothesis is the first step towards conducting original research. Such research may prove or disprove the proposed hypothesis. Case reports, case series, online surveys and other observational studies, clinical trials, and narrative reviews help to generate hypotheses. Observational and interventional studies help to test hypotheses. A good hypothesis is usually based on previous evidence-based reports. Hypotheses without evidence-based justification and a priori ideas are not received favourably by the scientific community. Original research to test a hypothesis should be carefully planned to ensure appropriate methodology and adequate statistical power. While hypotheses can challenge conventional thinking and may be controversial, they should not be destructive. A hypothesis should be tested by ethically sound experiments with meaningful ethical and clinical implications. The coronavirus disease 2019 pandemic has brought into sharp focus numerous hypotheses, some of which were proven (e.g. effectiveness of corticosteroids in those with hypoxia) while others were disproven (e.g. ineffectiveness of hydroxychloroquine and ivermectin).

Graphical Abstract

DEFINING WORKING AND STANDALONE SCIENTIFIC HYPOTHESES

Science is the systematized description of natural truths and facts. Routine observations of existing life phenomena lead to the creative thinking and generation of ideas about mechanisms of such phenomena and related human interventions. Such ideas presented in a structured format can be viewed as hypotheses. After generating a hypothesis, it is necessary to test it to prove its validity. Thus, hypothesis can be defined as a proposed mechanism of a naturally occurring event or a proposed outcome of an intervention. 1 , 2

Hypothesis testing requires choosing the most appropriate methodology and adequately powering statistically the study to be able to “prove” or “disprove” it within predetermined and widely accepted levels of certainty. This entails sample size calculation that often takes into account previously published observations and pilot studies. 2 , 3 In the era of digitization, hypothesis generation and testing may benefit from the availability of numerous platforms for data dissemination, social networking, and expert validation. Related expert evaluations may reveal strengths and limitations of proposed ideas at early stages of post-publication promotion, preventing the implementation of unsupported controversial points. 4

Thus, hypothesis generation is an important initial step in the research workflow, reflecting accumulating evidence and experts' stance. In this article, we overview the genesis and importance of scientific hypotheses and their relevance in the era of the coronavirus disease 2019 (COVID-19) pandemic.

DO WE NEED HYPOTHESES FOR ALL STUDY DESIGNS?

Broadly, research can be categorized as primary or secondary. In the context of medicine, primary research may include real-life observations of disease presentations and outcomes. Single case descriptions, which often lead to new ideas and hypotheses, serve as important starting points or justifications for case series and cohort studies. The importance of case descriptions is particularly evident in the context of the COVID-19 pandemic when unique, educational case reports have heralded a new era in clinical medicine. 5

Case series serve similar purpose to single case reports, but are based on a slightly larger quantum of information. Observational studies, including online surveys, describe the existing phenomena at a larger scale, often involving various control groups. Observational studies include variable-scale epidemiological investigations at different time points. Interventional studies detail the results of therapeutic interventions.

Secondary research is based on already published literature and does not directly involve human or animal subjects. Review articles are generated by secondary research. These could be systematic reviews which follow methods akin to primary research but with the unit of study being published papers rather than humans or animals. Systematic reviews have a rigid structure with a mandatory search strategy encompassing multiple databases, systematic screening of search results against pre-defined inclusion and exclusion criteria, critical appraisal of study quality and an optional component of collating results across studies quantitatively to derive summary estimates (meta-analysis). 6 Narrative reviews, on the other hand, have a more flexible structure. Systematic literature searches to minimise bias in selection of articles are highly recommended but not mandatory. 7 Narrative reviews are influenced by the authors' viewpoint who may preferentially analyse selected sets of articles. 8

In relation to primary research, case studies and case series are generally not driven by a working hypothesis. Rather, they serve as a basis to generate a hypothesis. Observational or interventional studies should have a hypothesis for choosing research design and sample size. The results of observational and interventional studies further lead to the generation of new hypotheses, testing of which forms the basis of future studies. Review articles, on the other hand, may not be hypothesis-driven, but form fertile ground to generate future hypotheses for evaluation. Fig. 1 summarizes which type of studies are hypothesis-driven and which lead on to hypothesis generation.

STANDARDS OF WORKING AND SCIENTIFIC HYPOTHESES

A review of the published literature did not enable the identification of clearly defined standards for working and scientific hypotheses. It is essential to distinguish influential versus not influential hypotheses, evidence-based hypotheses versus a priori statements and ideas, ethical versus unethical, or potentially harmful ideas. The following points are proposed for consideration while generating working and scientific hypotheses. 1 , 2 Table 1 summarizes these points.

Evidence-based data

A scientific hypothesis should have a sound basis on previously published literature as well as the scientist's observations. Randomly generated (a priori) hypotheses are unlikely to be proven. A thorough literature search should form the basis of a hypothesis based on published evidence. 7

Unless a scientific hypothesis can be tested, it can neither be proven nor be disproven. Therefore, a scientific hypothesis should be amenable to testing with the available technologies and the present understanding of science.

Supported by pilot studies

If a hypothesis is based purely on a novel observation by the scientist in question, it should be grounded on some preliminary studies to support it. For example, if a drug that targets a specific cell population is hypothesized to be useful in a particular disease setting, then there must be some preliminary evidence that the specific cell population plays a role in driving that disease process.

Testable by ethical studies

The hypothesis should be testable by experiments that are ethically acceptable. 9 For example, a hypothesis that parachutes reduce mortality from falls from an airplane cannot be tested using a randomized controlled trial. 10 This is because it is obvious that all those jumping from a flying plane without a parachute would likely die. Similarly, the hypothesis that smoking tobacco causes lung cancer cannot be tested by a clinical trial that makes people take up smoking (since there is considerable evidence for the health hazards associated with smoking). Instead, long-term observational studies comparing outcomes in those who smoke and those who do not, as was performed in the landmark epidemiological case control study by Doll and Hill, 11 are more ethical and practical.

Balance between scientific temper and controversy

Novel findings, including novel hypotheses, particularly those that challenge established norms, are bound to face resistance for their wider acceptance. Such resistance is inevitable until the time such findings are proven with appropriate scientific rigor. However, hypotheses that generate controversy are generally unwelcome. For example, at the time the pandemic of human immunodeficiency virus (HIV) and AIDS was taking foot, there were numerous deniers that refused to believe that HIV caused AIDS. 12 , 13 Similarly, at a time when climate change is causing catastrophic changes to weather patterns worldwide, denial that climate change is occurring and consequent attempts to block climate change are certainly unwelcome. 14 The denialism and misinformation during the COVID-19 pandemic, including unfortunate examples of vaccine hesitancy, are more recent examples of controversial hypotheses not backed by science. 15 , 16 An example of a controversial hypothesis that was a revolutionary scientific breakthrough was the hypothesis put forth by Warren and Marshall that Helicobacter pylori causes peptic ulcers. Initially, the hypothesis that a microorganism could cause gastritis and gastric ulcers faced immense resistance. When the scientists that proposed the hypothesis themselves ingested H. pylori to induce gastritis in themselves, only then could they convince the wider world about their hypothesis. Such was the impact of the hypothesis was that Barry Marshall and Robin Warren were awarded the Nobel Prize in Physiology or Medicine in 2005 for this discovery. 17 , 18

DISTINGUISHING THE MOST INFLUENTIAL HYPOTHESES

Influential hypotheses are those that have stood the test of time. An archetype of an influential hypothesis is that proposed by Edward Jenner in the eighteenth century that cowpox infection protects against smallpox. While this observation had been reported for nearly a century before this time, it had not been suitably tested and publicised until Jenner conducted his experiments on a young boy by demonstrating protection against smallpox after inoculation with cowpox. 19 These experiments were the basis for widespread smallpox immunization strategies worldwide in the 20th century which resulted in the elimination of smallpox as a human disease today. 20

Other influential hypotheses are those which have been read and cited widely. An example of this is the hygiene hypothesis proposing an inverse relationship between infections in early life and allergies or autoimmunity in adulthood. An analysis reported that this hypothesis had been cited more than 3,000 times on Scopus. 1

LESSONS LEARNED FROM HYPOTHESES AMIDST THE COVID-19 PANDEMIC

The COVID-19 pandemic devastated the world like no other in recent memory. During this period, various hypotheses emerged, understandably so considering the public health emergency situation with innumerable deaths and suffering for humanity. Within weeks of the first reports of COVID-19, aberrant immune system activation was identified as a key driver of organ dysfunction and mortality in this disease. 21 Consequently, numerous drugs that suppress the immune system or abrogate the activation of the immune system were hypothesized to have a role in COVID-19. 22 One of the earliest drugs hypothesized to have a benefit was hydroxychloroquine. Hydroxychloroquine was proposed to interfere with Toll-like receptor activation and consequently ameliorate the aberrant immune system activation leading to pathology in COVID-19. 22 The drug was also hypothesized to have a prophylactic role in preventing infection or disease severity in COVID-19. It was also touted as a wonder drug for the disease by many prominent international figures. However, later studies which were well-designed randomized controlled trials failed to demonstrate any benefit of hydroxychloroquine in COVID-19. 23 , 24 , 25 , 26 Subsequently, azithromycin 27 , 28 and ivermectin 29 were hypothesized as potential therapies for COVID-19, but were not supported by evidence from randomized controlled trials. The role of vitamin D in preventing disease severity was also proposed, but has not been proven definitively until now. 30 , 31 On the other hand, randomized controlled trials identified the evidence supporting dexamethasone 32 and interleukin-6 pathway blockade with tocilizumab as effective therapies for COVID-19 in specific situations such as at the onset of hypoxia. 33 , 34 Clues towards the apparent effectiveness of various drugs against severe acute respiratory syndrome coronavirus 2 in vitro but their ineffectiveness in vivo have recently been identified. Many of these drugs are weak, lipophilic bases and some others induce phospholipidosis which results in apparent in vitro effectiveness due to non-specific off-target effects that are not replicated inside living systems. 35 , 36

Another hypothesis proposed was the association of the routine policy of vaccination with Bacillus Calmette-Guerin (BCG) with lower deaths due to COVID-19. This hypothesis emerged in the middle of 2020 when COVID-19 was still taking foot in many parts of the world. 37 , 38 Subsequently, many countries which had lower deaths at that time point went on to have higher numbers of mortality, comparable to other areas of the world. Furthermore, the hypothesis that BCG vaccination reduced COVID-19 mortality was a classic example of ecological fallacy. Associations between population level events (ecological studies; in this case, BCG vaccination and COVID-19 mortality) cannot be directly extrapolated to the individual level. Furthermore, such associations cannot per se be attributed as causal in nature, and can only serve to generate hypotheses that need to be tested at the individual level. 39

IS TRADITIONAL PEER REVIEW EFFICIENT FOR EVALUATION OF WORKING AND SCIENTIFIC HYPOTHESES?

Traditionally, publication after peer review has been considered the gold standard before any new idea finds acceptability amongst the scientific community. Getting a work (including a working or scientific hypothesis) reviewed by experts in the field before experiments are conducted to prove or disprove it helps to refine the idea further as well as improve the experiments planned to test the hypothesis. 40 A route towards this has been the emergence of journals dedicated to publishing hypotheses such as the Central Asian Journal of Medical Hypotheses and Ethics. 41 Another means of publishing hypotheses is through registered research protocols detailing the background, hypothesis, and methodology of a particular study. If such protocols are published after peer review, then the journal commits to publishing the completed study irrespective of whether the study hypothesis is proven or disproven. 42 In the post-pandemic world, online research methods such as online surveys powered via social media channels such as Twitter and Instagram might serve as critical tools to generate as well as to preliminarily test the appropriateness of hypotheses for further evaluation. 43 , 44

Some radical hypotheses might be difficult to publish after traditional peer review. These hypotheses might only be acceptable by the scientific community after they are tested in research studies. Preprints might be a way to disseminate such controversial and ground-breaking hypotheses. 45 However, scientists might prefer to keep their hypotheses confidential for the fear of plagiarism of ideas, avoiding online posting and publishing until they have tested the hypotheses.

SUGGESTIONS ON GENERATING AND PUBLISHING HYPOTHESES

Publication of hypotheses is important, however, a balance is required between scientific temper and controversy. Journal editors and reviewers might keep in mind these specific points, summarized in Table 2 and detailed hereafter, while judging the merit of hypotheses for publication. Keeping in mind the ethical principle of primum non nocere, a hypothesis should be published only if it is testable in a manner that is ethically appropriate. 46 Such hypotheses should be grounded in reality and lend themselves to further testing to either prove or disprove them. It must be considered that subsequent experiments to prove or disprove a hypothesis have an equal chance of failing or succeeding, akin to tossing a coin. A pre-conceived belief that a hypothesis is unlikely to be proven correct should not form the basis of rejection of such a hypothesis for publication. In this context, hypotheses generated after a thorough literature search to identify knowledge gaps or based on concrete clinical observations on a considerable number of patients (as opposed to random observations on a few patients) are more likely to be acceptable for publication by peer-reviewed journals. Also, hypotheses should be considered for publication or rejection based on their implications for science at large rather than whether the subsequent experiments to test them end up with results in favour of or against the original hypothesis.

Hypotheses form an important part of the scientific literature. The COVID-19 pandemic has reiterated the importance and relevance of hypotheses for dealing with public health emergencies and highlighted the need for evidence-based and ethical hypotheses. A good hypothesis is testable in a relevant study design, backed by preliminary evidence, and has positive ethical and clinical implications. General medical journals might consider publishing hypotheses as a specific article type to enable more rapid advancement of science.

Disclosure: The authors have no potential conflicts of interest to disclose.

Author Contributions:

• Data curation: Gasparyan AY, Misra DP, Zimba O, Yessirkepov M, Agarwal V, Kitas GD.

Educational resources and simple solutions for your research journey

What is a Research Hypothesis: How to Write it, Types, and Examples

Any research begins with a research question and a research hypothesis . A research question alone may not suffice to design the experiment(s) needed to answer it. A hypothesis is central to the scientific method. But what is a hypothesis ? A hypothesis is a testable statement that proposes a possible explanation to a phenomenon, and it may include a prediction. Next, you may ask what is a research hypothesis ? Simply put, a research hypothesis is a prediction or educated guess about the relationship between the variables that you want to investigate.  

It is important to be thorough when developing your research hypothesis. Shortcomings in the framing of a hypothesis can affect the study design and the results. A better understanding of the research hypothesis definition and characteristics of a good hypothesis will make it easier for you to develop your own hypothesis for your research. Let’s dive in to know more about the types of research hypothesis , how to write a research hypothesis , and some research hypothesis examples .  

Table of Contents

What is a hypothesis ?  

A hypothesis is based on the existing body of knowledge in a study area. Framed before the data are collected, a hypothesis states the tentative relationship between independent and dependent variables, along with a prediction of the outcome.  

What is a research hypothesis ?  

Young researchers starting out their journey are usually brimming with questions like “ What is a hypothesis ?” “ What is a research hypothesis ?” “How can I write a good research hypothesis ?”   

A research hypothesis is a statement that proposes a possible explanation for an observable phenomenon or pattern. It guides the direction of a study and predicts the outcome of the investigation. A research hypothesis is testable, i.e., it can be supported or disproven through experimentation or observation.     

Characteristics of a good hypothesis  

Here are the characteristics of a good hypothesis :  

• Clearly formulated and free of language errors and ambiguity  
• Concise and not unnecessarily verbose  
• Has clearly defined variables  
• Testable and stated in a way that allows for it to be disproven  
• Can be tested using a research design that is feasible, ethical, and practical   
• Specific and relevant to the research problem  
• Rooted in a thorough literature search  
• Can generate new knowledge or understanding.  

How to create an effective research hypothesis  

A study begins with the formulation of a research question. A researcher then performs background research. This background information forms the basis for building a good research hypothesis . The researcher then performs experiments, collects, and analyzes the data, interprets the findings, and ultimately, determines if the findings support or negate the original hypothesis.  

Let’s look at each step for creating an effective, testable, and good research hypothesis :  

• Identify a research problem or question: Start by identifying a specific research problem.   
• Review the literature: Conduct an in-depth review of the existing literature related to the research problem to grasp the current knowledge and gaps in the field.   
• Formulate a clear and testable hypothesis : Based on the research question, use existing knowledge to form a clear and testable hypothesis . The hypothesis should state a predicted relationship between two or more variables that can be measured and manipulated. Improve the original draft till it is clear and meaningful.  
• State the null hypothesis: The null hypothesis is a statement that there is no relationship between the variables you are studying.   
• Define the population and sample: Clearly define the population you are studying and the sample you will be using for your research.  
• Select appropriate methods for testing the hypothesis: Select appropriate research methods, such as experiments, surveys, or observational studies, which will allow you to test your research hypothesis .  

Remember that creating a research hypothesis is an iterative process, i.e., you might have to revise it based on the data you collect. You may need to test and reject several hypotheses before answering the research problem.  

How to write a research hypothesis  

When you start writing a research hypothesis , you use an “if–then” statement format, which states the predicted relationship between two or more variables. Clearly identify the independent variables (the variables being changed) and the dependent variables (the variables being measured), as well as the population you are studying. Review and revise your hypothesis as needed.  

An example of a research hypothesis in this format is as follows:  

“ If [athletes] follow [cold water showers daily], then their [endurance] increases.”  

Population: athletes  

Independent variable: daily cold water showers  

Dependent variable: endurance  

You may have understood the characteristics of a good hypothesis . But note that a research hypothesis is not always confirmed; a researcher should be prepared to accept or reject the hypothesis based on the study findings.  

Research hypothesis checklist  

Following from above, here is a 10-point checklist for a good research hypothesis :  

• Testable: A research hypothesis should be able to be tested via experimentation or observation.  
• Specific: A research hypothesis should clearly state the relationship between the variables being studied.  
• Based on prior research: A research hypothesis should be based on existing knowledge and previous research in the field.  
• Falsifiable: A research hypothesis should be able to be disproven through testing.  
• Clear and concise: A research hypothesis should be stated in a clear and concise manner.  
• Logical: A research hypothesis should be logical and consistent with current understanding of the subject.  
• Relevant: A research hypothesis should be relevant to the research question and objectives.  
• Feasible: A research hypothesis should be feasible to test within the scope of the study.  
• Reflects the population: A research hypothesis should consider the population or sample being studied.  
• Uncomplicated: A good research hypothesis is written in a way that is easy for the target audience to understand.  

By following this research hypothesis checklist , you will be able to create a research hypothesis that is strong, well-constructed, and more likely to yield meaningful results.  

Types of research hypothesis  

Different types of research hypothesis are used in scientific research:  

1. Null hypothesis:

A null hypothesis states that there is no change in the dependent variable due to changes to the independent variable. This means that the results are due to chance and are not significant. A null hypothesis is denoted as H0 and is stated as the opposite of what the alternative hypothesis states.   

Example: “ The newly identified virus is not zoonotic .”  

2. Alternative hypothesis:

This states that there is a significant difference or relationship between the variables being studied. It is denoted as H1 or Ha and is usually accepted or rejected in favor of the null hypothesis.  

Example: “ The newly identified virus is zoonotic .”  

3. Directional hypothesis :

This specifies the direction of the relationship or difference between variables; therefore, it tends to use terms like increase, decrease, positive, negative, more, or less.   

Example: “ The inclusion of intervention X decreases infant mortality compared to the original treatment .”   

4. Non-directional hypothesis:

While it does not predict the exact direction or nature of the relationship between the two variables, a non-directional hypothesis states the existence of a relationship or difference between variables but not the direction, nature, or magnitude of the relationship. A non-directional hypothesis may be used when there is no underlying theory or when findings contradict previous research.  

Example, “ Cats and dogs differ in the amount of affection they express .”  

5. Simple hypothesis :

A simple hypothesis only predicts the relationship between one independent and another independent variable.  

Example: “ Applying sunscreen every day slows skin aging .”  

6 . Complex hypothesis :

A complex hypothesis states the relationship or difference between two or more independent and dependent variables.   

Example: “ Applying sunscreen every day slows skin aging, reduces sun burn, and reduces the chances of skin cancer .” (Here, the three dependent variables are slowing skin aging, reducing sun burn, and reducing the chances of skin cancer.)  

7. Associative hypothesis:  

An associative hypothesis states that a change in one variable results in the change of the other variable. The associative hypothesis defines interdependency between variables.  

Example: “ There is a positive association between physical activity levels and overall health .”  

8 . Causal hypothesis:

A causal hypothesis proposes a cause-and-effect interaction between variables.  

Example: “ Long-term alcohol use causes liver damage .”  

Note that some of the types of research hypothesis mentioned above might overlap. The types of hypothesis chosen will depend on the research question and the objective of the study.  

Research hypothesis examples  

Here are some good research hypothesis examples :  

“The use of a specific type of therapy will lead to a reduction in symptoms of depression in individuals with a history of major depressive disorder.”  

“Providing educational interventions on healthy eating habits will result in weight loss in overweight individuals.”  

“Plants that are exposed to certain types of music will grow taller than those that are not exposed to music.”  

“The use of the plant growth regulator X will lead to an increase in the number of flowers produced by plants.”  

Characteristics that make a research hypothesis weak are unclear variables, unoriginality, being too general or too vague, and being untestable. A weak hypothesis leads to weak research and improper methods.   

Some bad research hypothesis examples (and the reasons why they are “bad”) are as follows:  

“This study will show that treatment X is better than any other treatment . ” (This statement is not testable, too broad, and does not consider other treatments that may be effective.)  

“This study will prove that this type of therapy is effective for all mental disorders . ” (This statement is too broad and not testable as mental disorders are complex and different disorders may respond differently to different types of therapy.)  

“Plants can communicate with each other through telepathy . ” (This statement is not testable and lacks a scientific basis.)  

Importance of testable hypothesis  

If a research hypothesis is not testable, the results will not prove or disprove anything meaningful. The conclusions will be vague at best. A testable hypothesis helps a researcher focus on the study outcome and understand the implication of the question and the different variables involved. A testable hypothesis helps a researcher make precise predictions based on prior research.  

To be considered testable, there must be a way to prove that the hypothesis is true or false; further, the results of the hypothesis must be reproducible.  

Frequently Asked Questions (FAQs) on research hypothesis  

1. What is the difference between research question and research hypothesis ?  

A research question defines the problem and helps outline the study objective(s). It is an open-ended statement that is exploratory or probing in nature. Therefore, it does not make predictions or assumptions. It helps a researcher identify what information to collect. A research hypothesis , however, is a specific, testable prediction about the relationship between variables. Accordingly, it guides the study design and data analysis approach.

2. When to reject null hypothesis ?

A null hypothesis should be rejected when the evidence from a statistical test shows that it is unlikely to be true. This happens when the test statistic (e.g., p -value) is less than the defined significance level (e.g., 0.05). Rejecting the null hypothesis does not necessarily mean that the alternative hypothesis is true; it simply means that the evidence found is not compatible with the null hypothesis.  

3. How can I be sure my hypothesis is testable?  

A testable hypothesis should be specific and measurable, and it should state a clear relationship between variables that can be tested with data. To ensure that your hypothesis is testable, consider the following:  

• Clearly define the key variables in your hypothesis. You should be able to measure and manipulate these variables in a way that allows you to test the hypothesis.  
• The hypothesis should predict a specific outcome or relationship between variables that can be measured or quantified.   
• You should be able to collect the necessary data within the constraints of your study.  
• It should be possible for other researchers to replicate your study, using the same methods and variables.   
• Your hypothesis should be testable by using appropriate statistical analysis techniques, so you can draw conclusions, and make inferences about the population from the sample data.  
• The hypothesis should be able to be disproven or rejected through the collection of data.  

4. How do I revise my research hypothesis if my data does not support it?  

If your data does not support your research hypothesis , you will need to revise it or develop a new one. You should examine your data carefully and identify any patterns or anomalies, re-examine your research question, and/or revisit your theory to look for any alternative explanations for your results. Based on your review of the data, literature, and theories, modify your research hypothesis to better align it with the results you obtained. Use your revised hypothesis to guide your research design and data collection. It is important to remain objective throughout the process.  

5. I am performing exploratory research. Do I need to formulate a research hypothesis?  

As opposed to “confirmatory” research, where a researcher has some idea about the relationship between the variables under investigation, exploratory research (or hypothesis-generating research) looks into a completely new topic about which limited information is available. Therefore, the researcher will not have any prior hypotheses. In such cases, a researcher will need to develop a post-hoc hypothesis. A post-hoc research hypothesis is generated after these results are known.  

6. How is a research hypothesis different from a research question?

A research question is an inquiry about a specific topic or phenomenon, typically expressed as a question. It seeks to explore and understand a particular aspect of the research subject. In contrast, a research hypothesis is a specific statement or prediction that suggests an expected relationship between variables. It is formulated based on existing knowledge or theories and guides the research design and data analysis.

7. Can a research hypothesis change during the research process?

Yes, research hypotheses can change during the research process. As researchers collect and analyze data, new insights and information may emerge that require modification or refinement of the initial hypotheses. This can be due to unexpected findings, limitations in the original hypotheses, or the need to explore additional dimensions of the research topic. Flexibility is crucial in research, allowing for adaptation and adjustment of hypotheses to align with the evolving understanding of the subject matter.

8. How many hypotheses should be included in a research study?

The number of research hypotheses in a research study varies depending on the nature and scope of the research. It is not necessary to have multiple hypotheses in every study. Some studies may have only one primary hypothesis, while others may have several related hypotheses. The number of hypotheses should be determined based on the research objectives, research questions, and the complexity of the research topic. It is important to ensure that the hypotheses are focused, testable, and directly related to the research aims.

9. Can research hypotheses be used in qualitative research?

Yes, research hypotheses can be used in qualitative research, although they are more commonly associated with quantitative research. In qualitative research, hypotheses may be formulated as tentative or exploratory statements that guide the investigation. Instead of testing hypotheses through statistical analysis, qualitative researchers may use the hypotheses to guide data collection and analysis, seeking to uncover patterns, themes, or relationships within the qualitative data. The emphasis in qualitative research is often on generating insights and understanding rather than confirming or rejecting specific research hypotheses through statistical testing.

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Research Hypothesis In Psychology: Types, & Examples

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A research hypothesis, in its plural form “hypotheses,” is a specific, testable prediction about the anticipated results of a study, established at its outset. It is a key component of the scientific method .

Hypotheses connect theory to data and guide the research process towards expanding scientific understanding

Some key points about hypotheses:

• A hypothesis expresses an expected pattern or relationship. It connects the variables under investigation.
• It is stated in clear, precise terms before any data collection or analysis occurs. This makes the hypothesis testable.
• A hypothesis must be falsifiable. It should be possible, even if unlikely in practice, to collect data that disconfirms rather than supports the hypothesis.
• Hypotheses guide research. Scientists design studies to explicitly evaluate hypotheses about how nature works.
• For a hypothesis to be valid, it must be testable against empirical evidence. The evidence can then confirm or disprove the testable predictions.
• Hypotheses are informed by background knowledge and observation, but go beyond what is already known to propose an explanation of how or why something occurs.

Predictions typically arise from a thorough knowledge of the research literature, curiosity about real-world problems or implications, and integrating this to advance theory. They build on existing literature while providing new insight.

Types of Research Hypotheses

Alternative hypothesis.

The research hypothesis is often called the alternative or experimental hypothesis in experimental research.

It typically suggests a potential relationship between two key variables: the independent variable, which the researcher manipulates, and the dependent variable, which is measured based on those changes.

The alternative hypothesis states a relationship exists between the two variables being studied (one variable affects the other).

A hypothesis is a testable statement or prediction about the relationship between two or more variables. It is a key component of the scientific method. Some key points about hypotheses:

• Important hypotheses lead to predictions that can be tested empirically. The evidence can then confirm or disprove the testable predictions.

In summary, a hypothesis is a precise, testable statement of what researchers expect to happen in a study and why. Hypotheses connect theory to data and guide the research process towards expanding scientific understanding.

An experimental hypothesis predicts what change(s) will occur in the dependent variable when the independent variable is manipulated.

It states that the results are not due to chance and are significant in supporting the theory being investigated.

The alternative hypothesis can be directional, indicating a specific direction of the effect, or non-directional, suggesting a difference without specifying its nature. It’s what researchers aim to support or demonstrate through their study.

Null Hypothesis

The null hypothesis states no relationship exists between the two variables being studied (one variable does not affect the other). There will be no changes in the dependent variable due to manipulating the independent variable.

It states results are due to chance and are not significant in supporting the idea being investigated.

The null hypothesis, positing no effect or relationship, is a foundational contrast to the research hypothesis in scientific inquiry. It establishes a baseline for statistical testing, promoting objectivity by initiating research from a neutral stance.

Many statistical methods are tailored to test the null hypothesis, determining the likelihood of observed results if no true effect exists.

This dual-hypothesis approach provides clarity, ensuring that research intentions are explicit, and fosters consistency across scientific studies, enhancing the standardization and interpretability of research outcomes.

Nondirectional Hypothesis

A non-directional hypothesis, also known as a two-tailed hypothesis, predicts that there is a difference or relationship between two variables but does not specify the direction of this relationship.

It merely indicates that a change or effect will occur without predicting which group will have higher or lower values.

For example, “There is a difference in performance between Group A and Group B” is a non-directional hypothesis.

Directional Hypothesis

A directional (one-tailed) hypothesis predicts the nature of the effect of the independent variable on the dependent variable. It predicts in which direction the change will take place. (i.e., greater, smaller, less, more)

It specifies whether one variable is greater, lesser, or different from another, rather than just indicating that there’s a difference without specifying its nature.

For example, “Exercise increases weight loss” is a directional hypothesis.

Falsifiability

The Falsification Principle, proposed by Karl Popper , is a way of demarcating science from non-science. It suggests that for a theory or hypothesis to be considered scientific, it must be testable and irrefutable.

Falsifiability emphasizes that scientific claims shouldn’t just be confirmable but should also have the potential to be proven wrong.

It means that there should exist some potential evidence or experiment that could prove the proposition false.

However many confirming instances exist for a theory, it only takes one counter observation to falsify it. For example, the hypothesis that “all swans are white,” can be falsified by observing a black swan.

For Popper, science should attempt to disprove a theory rather than attempt to continually provide evidence to support a research hypothesis.

Can a Hypothesis be Proven?

Hypotheses make probabilistic predictions. They state the expected outcome if a particular relationship exists. However, a study result supporting a hypothesis does not definitively prove it is true.

All studies have limitations. There may be unknown confounding factors or issues that limit the certainty of conclusions. Additional studies may yield different results.

In science, hypotheses can realistically only be supported with some degree of confidence, not proven. The process of science is to incrementally accumulate evidence for and against hypothesized relationships in an ongoing pursuit of better models and explanations that best fit the empirical data. But hypotheses remain open to revision and rejection if that is where the evidence leads.

• Disproving a hypothesis is definitive. Solid disconfirmatory evidence will falsify a hypothesis and require altering or discarding it based on the evidence.
• However, confirming evidence is always open to revision. Other explanations may account for the same results, and additional or contradictory evidence may emerge over time.

We can never 100% prove the alternative hypothesis. Instead, we see if we can disprove, or reject the null hypothesis.

If we reject the null hypothesis, this doesn’t mean that our alternative hypothesis is correct but does support the alternative/experimental hypothesis.

Upon analysis of the results, an alternative hypothesis can be rejected or supported, but it can never be proven to be correct. We must avoid any reference to results proving a theory as this implies 100% certainty, and there is always a chance that evidence may exist which could refute a theory.

How to Write a Hypothesis

• Identify variables . The researcher manipulates the independent variable and the dependent variable is the measured outcome.
• Operationalized the variables being investigated . Operationalization of a hypothesis refers to the process of making the variables physically measurable or testable, e.g. if you are about to study aggression, you might count the number of punches given by participants.
• Decide on a direction for your prediction . If there is evidence in the literature to support a specific effect of the independent variable on the dependent variable, write a directional (one-tailed) hypothesis. If there are limited or ambiguous findings in the literature regarding the effect of the independent variable on the dependent variable, write a non-directional (two-tailed) hypothesis.
• Make it Testable : Ensure your hypothesis can be tested through experimentation or observation. It should be possible to prove it false (principle of falsifiability).
• Clear & concise language . A strong hypothesis is concise (typically one to two sentences long), and formulated using clear and straightforward language, ensuring it’s easily understood and testable.

Consider a hypothesis many teachers might subscribe to: students work better on Monday morning than on Friday afternoon (IV=Day, DV= Standard of work).

Now, if we decide to study this by giving the same group of students a lesson on a Monday morning and a Friday afternoon and then measuring their immediate recall of the material covered in each session, we would end up with the following:

• The alternative hypothesis states that students will recall significantly more information on a Monday morning than on a Friday afternoon.
• The null hypothesis states that there will be no significant difference in the amount recalled on a Monday morning compared to a Friday afternoon. Any difference will be due to chance or confounding factors.

More Examples

• Memory : Participants exposed to classical music during study sessions will recall more items from a list than those who studied in silence.
• Social Psychology : Individuals who frequently engage in social media use will report higher levels of perceived social isolation compared to those who use it infrequently.
• Developmental Psychology : Children who engage in regular imaginative play have better problem-solving skills than those who don’t.
• Clinical Psychology : Cognitive-behavioral therapy will be more effective in reducing symptoms of anxiety over a 6-month period compared to traditional talk therapy.
• Cognitive Psychology : Individuals who multitask between various electronic devices will have shorter attention spans on focused tasks than those who single-task.
• Health Psychology : Patients who practice mindfulness meditation will experience lower levels of chronic pain compared to those who don’t meditate.
• Organizational Psychology : Employees in open-plan offices will report higher levels of stress than those in private offices.
• Behavioral Psychology : Rats rewarded with food after pressing a lever will press it more frequently than rats who receive no reward.

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What Is A Research (Scientific) Hypothesis? A plain-language explainer + examples

By:  Derek Jansen (MBA)  | Reviewed By: Dr Eunice Rautenbach | June 2020

If you’re new to the world of research, or it’s your first time writing a dissertation or thesis, you’re probably noticing that the words “research hypothesis” and “scientific hypothesis” are used quite a bit, and you’re wondering what they mean in a research context .

“Hypothesis” is one of those words that people use loosely, thinking they understand what it means. However, it has a very specific meaning within academic research. So, it’s important to understand the exact meaning before you start hypothesizing. 

Research Hypothesis 101

• What is a hypothesis ?
• What is a research hypothesis (scientific hypothesis)?
• Requirements for a research hypothesis
• Definition of a research hypothesis
• The null hypothesis

What is a hypothesis?

Let’s start with the general definition of a hypothesis (not a research hypothesis or scientific hypothesis), according to the Cambridge Dictionary:

Hypothesis: an idea or explanation for something that is based on known facts but has not yet been proved.

In other words, it’s a statement that provides an explanation for why or how something works, based on facts (or some reasonable assumptions), but that has not yet been specifically tested . For example, a hypothesis might look something like this:

Hypothesis: sleep impacts academic performance.

This statement predicts that academic performance will be influenced by the amount and/or quality of sleep a student engages in – sounds reasonable, right? It’s based on reasonable assumptions , underpinned by what we currently know about sleep and health (from the existing literature). So, loosely speaking, we could call it a hypothesis, at least by the dictionary definition.

But that’s not good enough…

Unfortunately, that’s not quite sophisticated enough to describe a research hypothesis (also sometimes called a scientific hypothesis), and it wouldn’t be acceptable in a dissertation, thesis or research paper . In the world of academic research, a statement needs a few more criteria to constitute a true research hypothesis .

What is a research hypothesis?

A research hypothesis (also called a scientific hypothesis) is a statement about the expected outcome of a study (for example, a dissertation or thesis). To constitute a quality hypothesis, the statement needs to have three attributes – specificity , clarity and testability .

Let’s take a look at these more closely.

Need a helping hand?

Hypothesis Essential #1: Specificity & Clarity

A good research hypothesis needs to be extremely clear and articulate about both what’ s being assessed (who or what variables are involved ) and the expected outcome (for example, a difference between groups, a relationship between variables, etc.).

Let’s stick with our sleepy students example and look at how this statement could be more specific and clear.

Hypothesis: Students who sleep at least 8 hours per night will, on average, achieve higher grades in standardised tests than students who sleep less than 8 hours a night.

As you can see, the statement is very specific as it identifies the variables involved (sleep hours and test grades), the parties involved (two groups of students), as well as the predicted relationship type (a positive relationship). There’s no ambiguity or uncertainty about who or what is involved in the statement, and the expected outcome is clear.

Contrast that to the original hypothesis we looked at – “Sleep impacts academic performance” – and you can see the difference. “Sleep” and “academic performance” are both comparatively vague , and there’s no indication of what the expected relationship direction is (more sleep or less sleep). As you can see, specificity and clarity are key.

Hypothesis Essential #2: Testability (Provability)

A statement must be testable to qualify as a research hypothesis. In other words, there needs to be a way to prove (or disprove) the statement. If it’s not testable, it’s not a hypothesis – simple as that.

For example, consider the hypothesis we mentioned earlier:

Hypothesis: Students who sleep at least 8 hours per night will, on average, achieve higher grades in standardised tests than students who sleep less than 8 hours a night.  

We could test this statement by undertaking a quantitative study involving two groups of students, one that gets 8 or more hours of sleep per night for a fixed period, and one that gets less. We could then compare the standardised test results for both groups to see if there’s a statistically significant difference. 

Again, if you compare this to the original hypothesis we looked at – “Sleep impacts academic performance” – you can see that it would be quite difficult to test that statement, primarily because it isn’t specific enough. How much sleep? By who? What type of academic performance?

So, remember the mantra – if you can’t test it, it’s not a hypothesis 🙂

Defining A Research Hypothesis

You’re still with us? Great! Let’s recap and pin down a clear definition of a hypothesis.

A research hypothesis (or scientific hypothesis) is a statement about an expected relationship between variables, or explanation of an occurrence, that is clear, specific and testable.

So, when you write up hypotheses for your dissertation or thesis, make sure that they meet all these criteria. If you do, you’ll not only have rock-solid hypotheses but you’ll also ensure a clear focus for your entire research project.

What about the null hypothesis?

You may have also heard the terms null hypothesis , alternative hypothesis, or H-zero thrown around. At a simple level, the null hypothesis is the counter-proposal to the original hypothesis.

For example, if the hypothesis predicts that there is a relationship between two variables (for example, sleep and academic performance), the null hypothesis would predict that there is no relationship between those variables.

At a more technical level, the null hypothesis proposes that no statistical significance exists in a set of given observations and that any differences are due to chance alone.

And there you have it – hypotheses in a nutshell. 

If you have any questions, be sure to leave a comment below and we’ll do our best to help you. If you need hands-on help developing and testing your hypotheses, consider our private coaching service , where we hold your hand through the research journey.

Psst... there’s more!

This post was based on one of our popular Research Bootcamps . If you're working on a research project, you'll definitely want to check this out ...

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16 Comments

Very useful information. I benefit more from getting more information in this regard.

Very great insight,educative and informative. Please give meet deep critics on many research data of public international Law like human rights, environment, natural resources, law of the sea etc

In a book I read a distinction is made between null, research, and alternative hypothesis. As far as I understand, alternative and research hypotheses are the same. Can you please elaborate? Best Afshin

This is a self explanatory, easy going site. I will recommend this to my friends and colleagues.

Very good definition. How can I cite your definition in my thesis? Thank you. Is nul hypothesis compulsory in a research?

It’s a counter-proposal to be proven as a rejection

Please what is the difference between alternate hypothesis and research hypothesis?

It is a very good explanation. However, it limits hypotheses to statistically tasteable ideas. What about for qualitative researches or other researches that involve quantitative data that don’t need statistical tests?

In qualitative research, one typically uses propositions, not hypotheses.

could you please elaborate it more

I’ve benefited greatly from these notes, thank you.

This is very helpful

well articulated ideas are presented here, thank you for being reliable sources of information

Excellent. Thanks for being clear and sound about the research methodology and hypothesis (quantitative research)

I have only a simple question regarding the null hypothesis. – Is the null hypothesis (Ho) known as the reversible hypothesis of the alternative hypothesis (H1? – How to test it in academic research?

this is very important note help me much more

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Chapter 12. Observational Study Designs

Bradley G. Hammill

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• Introduction
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Observational studies in clinical research can be classified as either analytic or descriptive ( Table 12–1 ). Analytic observational studies are similar to randomized, controlled clinical trials in that the goal is to estimate the causal effect of an exposure on an outcome. Also similar to trials, analytic observational studies always include some type of comparison group, against which the experience of the exposed group is compared. Well-designed analytic studies can generate strong evidence for or against a stated hypothesis. Descriptive studies, on the other hand, aim to describe the characteristics or experiences of a particular patient group. Even well-designed descriptive studies cannot be used to draw strong conclusions about the effect of an exposure on an outcome. Instead, these studies are often used to generate study questions that can then be tested by more rigorous methods.

Although many observational study designs are available to researchers ( 1 ), a few are most widely used and will be described below. The analytic study designs presented are the case-control study and the cohort study. The descriptive study designs presented are the ecologic study, the cross-sectional prevalence survey, and case reports or case series.

Case-Control Studies

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Non-Experimental Research

32 Observational Research

Learning objectives.

• List the various types of observational research methods and distinguish between each.
• Describe the strengths and weakness of each observational research method. 

What Is Observational Research?

The term observational research is used to refer to several different types of non-experimental studies in which behavior is systematically observed and recorded. The goal of observational research is to describe a variable or set of variables. More generally, the goal is to obtain a snapshot of specific characteristics of an individual, group, or setting. As described previously, observational research is non-experimental because nothing is manipulated or controlled, and as such we cannot arrive at causal conclusions using this approach. The data that are collected in observational research studies are often qualitative in nature but they may also be quantitative or both (mixed-methods). There are several different types of observational methods that will be described below.

Naturalistic Observation

Naturalistic observation  is an observational method that involves observing people’s behavior in the environment in which it typically occurs. Thus naturalistic observation is a type of field research (as opposed to a type of laboratory research). Jane Goodall’s famous research on chimpanzees is a classic example of naturalistic observation. Dr.  Goodall spent three decades observing chimpanzees in their natural environment in East Africa. She examined such things as chimpanzee’s social structure, mating patterns, gender roles, family structure, and care of offspring by observing them in the wild. However, naturalistic observation  could more simply involve observing shoppers in a grocery store, children on a school playground, or psychiatric inpatients in their wards. Researchers engaged in naturalistic observation usually make their observations as unobtrusively as possible so that participants are not aware that they are being studied. Such an approach is called disguised naturalistic observation .  Ethically, this method is considered to be acceptable if the participants remain anonymous and the behavior occurs in a public setting where people would not normally have an expectation of privacy. Grocery shoppers putting items into their shopping carts, for example, are engaged in public behavior that is easily observable by store employees and other shoppers. For this reason, most researchers would consider it ethically acceptable to observe them for a study. On the other hand, one of the arguments against the ethicality of the naturalistic observation of “bathroom behavior” discussed earlier in the book is that people have a reasonable expectation of privacy even in a public restroom and that this expectation was violated. 

In cases where it is not ethical or practical to conduct disguised naturalistic observation, researchers can conduct  undisguised naturalistic observation where the participants are made aware of the researcher presence and monitoring of their behavior. However, one concern with undisguised naturalistic observation is  reactivity. Reactivity refers to when a measure changes participants’ behavior. In the case of undisguised naturalistic observation, the concern with reactivity is that when people know they are being observed and studied, they may act differently than they normally would. This type of reactivity is known as the Hawthorne effect . For instance, you may act much differently in a bar if you know that someone is observing you and recording your behaviors and this would invalidate the study. So disguised observation is less reactive and therefore can have higher validity because people are not aware that their behaviors are being observed and recorded. However, we now know that people often become used to being observed and with time they begin to behave naturally in the researcher’s presence. In other words, over time people habituate to being observed. Think about reality shows like Big Brother or Survivor where people are constantly being observed and recorded. While they may be on their best behavior at first, in a fairly short amount of time they are flirting, having sex, wearing next to nothing, screaming at each other, and occasionally behaving in ways that are embarrassing.

Participant Observation

Another approach to data collection in observational research is participant observation. In  participant observation , researchers become active participants in the group or situation they are studying. Participant observation is very similar to naturalistic observation in that it involves observing people’s behavior in the environment in which it typically occurs. As with naturalistic observation, the data that are collected can include interviews (usually unstructured), notes based on their observations and interactions, documents, photographs, and other artifacts. The only difference between naturalistic observation and participant observation is that researchers engaged in participant observation become active members of the group or situations they are studying. The basic rationale for participant observation is that there may be important information that is only accessible to, or can be interpreted only by, someone who is an active participant in the group or situation. Like naturalistic observation, participant observation can be either disguised or undisguised. In disguised participant observation , the researchers pretend to be members of the social group they are observing and conceal their true identity as researchers.

In a famous example of disguised participant observation, Leon Festinger and his colleagues infiltrated a doomsday cult known as the Seekers, whose members believed that the apocalypse would occur on December 21, 1954. Interested in studying how members of the group would cope psychologically when the prophecy inevitably failed, they carefully recorded the events and reactions of the cult members in the days before and after the supposed end of the world. Unsurprisingly, the cult members did not give up their belief but instead convinced themselves that it was their faith and efforts that saved the world from destruction. Festinger and his colleagues later published a book about this experience, which they used to illustrate the theory of cognitive dissonance (Festinger, Riecken, & Schachter, 1956) [1] .

In contrast with undisguised participant observation ,  the researchers become a part of the group they are studying and they disclose their true identity as researchers to the group under investigation. Once again there are important ethical issues to consider with disguised participant observation.  First no informed consent can be obtained and second deception is being used. The researcher is deceiving the participants by intentionally withholding information about their motivations for being a part of the social group they are studying. But sometimes disguised participation is the only way to access a protective group (like a cult). Further, disguised participant observation is less prone to reactivity than undisguised participant observation. 

Rosenhan’s study (1973) [2]   of the experience of people in a psychiatric ward would be considered disguised participant observation because Rosenhan and his pseudopatients were admitted into psychiatric hospitals on the pretense of being patients so that they could observe the way that psychiatric patients are treated by staff. The staff and other patients were unaware of their true identities as researchers.

Another example of participant observation comes from a study by sociologist Amy Wilkins on a university-based religious organization that emphasized how happy its members were (Wilkins, 2008) [3] . Wilkins spent 12 months attending and participating in the group’s meetings and social events, and she interviewed several group members. In her study, Wilkins identified several ways in which the group “enforced” happiness—for example, by continually talking about happiness, discouraging the expression of negative emotions, and using happiness as a way to distinguish themselves from other groups.

One of the primary benefits of participant observation is that the researchers are in a much better position to understand the viewpoint and experiences of the people they are studying when they are a part of the social group. The primary limitation with this approach is that the mere presence of the observer could affect the behavior of the people being observed. While this is also a concern with naturalistic observation, additional concerns arise when researchers become active members of the social group they are studying because that they may change the social dynamics and/or influence the behavior of the people they are studying. Similarly, if the researcher acts as a participant observer there can be concerns with biases resulting from developing relationships with the participants. Concretely, the researcher may become less objective resulting in more experimenter bias.

Structured Observation

Another observational method is structured observation . Here the investigator makes careful observations of one or more specific behaviors in a particular setting that is more structured than the settings used in naturalistic or participant observation. Often the setting in which the observations are made is not the natural setting. Instead, the researcher may observe people in the laboratory environment. Alternatively, the researcher may observe people in a natural setting (like a classroom setting) that they have structured some way, for instance by introducing some specific task participants are to engage in or by introducing a specific social situation or manipulation.

Structured observation is very similar to naturalistic observation and participant observation in that in all three cases researchers are observing naturally occurring behavior; however, the emphasis in structured observation is on gathering quantitative rather than qualitative data. Researchers using this approach are interested in a limited set of behaviors. This allows them to quantify the behaviors they are observing. In other words, structured observation is less global than naturalistic or participant observation because the researcher engaged in structured observations is interested in a small number of specific behaviors. Therefore, rather than recording everything that happens, the researcher only focuses on very specific behaviors of interest.

Researchers Robert Levine and Ara Norenzayan used structured observation to study differences in the “pace of life” across countries (Levine & Norenzayan, 1999) [4] . One of their measures involved observing pedestrians in a large city to see how long it took them to walk 60 feet. They found that people in some countries walked reliably faster than people in other countries. For example, people in Canada and Sweden covered 60 feet in just under 13 seconds on average, while people in Brazil and Romania took close to 17 seconds. When structured observation  takes place in the complex and even chaotic “real world,” the questions of when, where, and under what conditions the observations will be made, and who exactly will be observed are important to consider. Levine and Norenzayan described their sampling process as follows:

“Male and female walking speed over a distance of 60 feet was measured in at least two locations in main downtown areas in each city. Measurements were taken during main business hours on clear summer days. All locations were flat, unobstructed, had broad sidewalks, and were sufficiently uncrowded to allow pedestrians to move at potentially maximum speeds. To control for the effects of socializing, only pedestrians walking alone were used. Children, individuals with obvious physical handicaps, and window-shoppers were not timed. Thirty-five men and 35 women were timed in most cities.” (p. 186).

Precise specification of the sampling process in this way makes data collection manageable for the observers, and it also provides some control over important extraneous variables. For example, by making their observations on clear summer days in all countries, Levine and Norenzayan controlled for effects of the weather on people’s walking speeds.  In Levine and Norenzayan’s study, measurement was relatively straightforward. They simply measured out a 60-foot distance along a city sidewalk and then used a stopwatch to time participants as they walked over that distance.

As another example, researchers Robert Kraut and Robert Johnston wanted to study bowlers’ reactions to their shots, both when they were facing the pins and then when they turned toward their companions (Kraut & Johnston, 1979) [5] . But what “reactions” should they observe? Based on previous research and their own pilot testing, Kraut and Johnston created a list of reactions that included “closed smile,” “open smile,” “laugh,” “neutral face,” “look down,” “look away,” and “face cover” (covering one’s face with one’s hands). The observers committed this list to memory and then practiced by coding the reactions of bowlers who had been videotaped. During the actual study, the observers spoke into an audio recorder, describing the reactions they observed. Among the most interesting results of this study was that bowlers rarely smiled while they still faced the pins. They were much more likely to smile after they turned toward their companions, suggesting that smiling is not purely an expression of happiness but also a form of social communication.

In yet another example (this one in a laboratory environment), Dov Cohen and his colleagues had observers rate the emotional reactions of participants who had just been deliberately bumped and insulted by a confederate after they dropped off a completed questionnaire at the end of a hallway. The confederate was posing as someone who worked in the same building and who was frustrated by having to close a file drawer twice in order to permit the participants to walk past them (first to drop off the questionnaire at the end of the hallway and once again on their way back to the room where they believed the study they signed up for was taking place). The two observers were positioned at different ends of the hallway so that they could read the participants’ body language and hear anything they might say. Interestingly, the researchers hypothesized that participants from the southern United States, which is one of several places in the world that has a “culture of honor,” would react with more aggression than participants from the northern United States, a prediction that was in fact supported by the observational data (Cohen, Nisbett, Bowdle, & Schwarz, 1996) [6] .

When the observations require a judgment on the part of the observers—as in the studies by Kraut and Johnston and Cohen and his colleagues—a process referred to as   coding is typically required . Coding generally requires clearly defining a set of target behaviors. The observers then categorize participants individually in terms of which behavior they have engaged in and the number of times they engaged in each behavior. The observers might even record the duration of each behavior. The target behaviors must be defined in such a way that guides different observers to code them in the same way. This difficulty with coding illustrates the issue of interrater reliability, as mentioned in Chapter 4. Researchers are expected to demonstrate the interrater reliability of their coding procedure by having multiple raters code the same behaviors independently and then showing that the different observers are in close agreement. Kraut and Johnston, for example, video recorded a subset of their participants’ reactions and had two observers independently code them. The two observers showed that they agreed on the reactions that were exhibited 97% of the time, indicating good interrater reliability.

One of the primary benefits of structured observation is that it is far more efficient than naturalistic and participant observation. Since the researchers are focused on specific behaviors this reduces time and expense. Also, often times the environment is structured to encourage the behaviors of interest which again means that researchers do not have to invest as much time in waiting for the behaviors of interest to naturally occur. Finally, researchers using this approach can clearly exert greater control over the environment. However, when researchers exert more control over the environment it may make the environment less natural which decreases external validity. It is less clear for instance whether structured observations made in a laboratory environment will generalize to a real world environment. Furthermore, since researchers engaged in structured observation are often not disguised there may be more concerns with reactivity.

Case Studies

A  case study   is an in-depth examination of an individual. Sometimes case studies are also completed on social units (e.g., a cult) and events (e.g., a natural disaster). Most commonly in psychology, however, case studies provide a detailed description and analysis of an individual. Often the individual has a rare or unusual condition or disorder or has damage to a specific region of the brain.

Like many observational research methods, case studies tend to be more qualitative in nature. Case study methods involve an in-depth, and often a longitudinal examination of an individual. Depending on the focus of the case study, individuals may or may not be observed in their natural setting. If the natural setting is not what is of interest, then the individual may be brought into a therapist’s office or a researcher’s lab for study. Also, the bulk of the case study report will focus on in-depth descriptions of the person rather than on statistical analyses. With that said some quantitative data may also be included in the write-up of a case study. For instance, an individual’s depression score may be compared to normative scores or their score before and after treatment may be compared. As with other qualitative methods, a variety of different methods and tools can be used to collect information on the case. For instance, interviews, naturalistic observation, structured observation, psychological testing (e.g., IQ test), and/or physiological measurements (e.g., brain scans) may be used to collect information on the individual.

HM is one of the most notorious case studies in psychology. HM suffered from intractable and very severe epilepsy. A surgeon localized HM’s epilepsy to his medial temporal lobe and in 1953 he removed large sections of his hippocampus in an attempt to stop the seizures. The treatment was a success, in that it resolved his epilepsy and his IQ and personality were unaffected. However, the doctors soon realized that HM exhibited a strange form of amnesia, called anterograde amnesia. HM was able to carry out a conversation and he could remember short strings of letters, digits, and words. Basically, his short term memory was preserved. However, HM could not commit new events to memory. He lost the ability to transfer information from his short-term memory to his long term memory, something memory researchers call consolidation. So while he could carry on a conversation with someone, he would completely forget the conversation after it ended. This was an extremely important case study for memory researchers because it suggested that there’s a dissociation between short-term memory and long-term memory, it suggested that these were two different abilities sub-served by different areas of the brain. It also suggested that the temporal lobes are particularly important for consolidating new information (i.e., for transferring information from short-term memory to long-term memory).

The history of psychology is filled with influential cases studies, such as Sigmund Freud’s description of “Anna O.” (see Note 6.1 “The Case of “Anna O.””) and John Watson and Rosalie Rayner’s description of Little Albert (Watson & Rayner, 1920) [7] , who allegedly learned to fear a white rat—along with other furry objects—when the researchers repeatedly made a loud noise every time the rat approached him.

The Case of “Anna O.”

Sigmund Freud used the case of a young woman he called “Anna O.” to illustrate many principles of his theory of psychoanalysis (Freud, 1961) [8] . (Her real name was Bertha Pappenheim, and she was an early feminist who went on to make important contributions to the field of social work.) Anna had come to Freud’s colleague Josef Breuer around 1880 with a variety of odd physical and psychological symptoms. One of them was that for several weeks she was unable to drink any fluids. According to Freud,

She would take up the glass of water that she longed for, but as soon as it touched her lips she would push it away like someone suffering from hydrophobia.…She lived only on fruit, such as melons, etc., so as to lessen her tormenting thirst. (p. 9)

But according to Freud, a breakthrough came one day while Anna was under hypnosis.

[S]he grumbled about her English “lady-companion,” whom she did not care for, and went on to describe, with every sign of disgust, how she had once gone into this lady’s room and how her little dog—horrid creature!—had drunk out of a glass there. The patient had said nothing, as she had wanted to be polite. After giving further energetic expression to the anger she had held back, she asked for something to drink, drank a large quantity of water without any difficulty, and awoke from her hypnosis with the glass at her lips; and thereupon the disturbance vanished, never to return. (p.9)

Freud’s interpretation was that Anna had repressed the memory of this incident along with the emotion that it triggered and that this was what had caused her inability to drink. Furthermore, he believed that her recollection of the incident, along with her expression of the emotion she had repressed, caused the symptom to go away.

As an illustration of Freud’s theory, the case study of Anna O. is quite effective. As evidence for the theory, however, it is essentially worthless. The description provides no way of knowing whether Anna had really repressed the memory of the dog drinking from the glass, whether this repression had caused her inability to drink, or whether recalling this “trauma” relieved the symptom. It is also unclear from this case study how typical or atypical Anna’s experience was.

Case studies are useful because they provide a level of detailed analysis not found in many other research methods and greater insights may be gained from this more detailed analysis. As a result of the case study, the researcher may gain a sharpened understanding of what might become important to look at more extensively in future more controlled research. Case studies are also often the only way to study rare conditions because it may be impossible to find a large enough sample of individuals with the condition to use quantitative methods. Although at first glance a case study of a rare individual might seem to tell us little about ourselves, they often do provide insights into normal behavior. The case of HM provided important insights into the role of the hippocampus in memory consolidation.

However, it is important to note that while case studies can provide insights into certain areas and variables to study, and can be useful in helping develop theories, they should never be used as evidence for theories. In other words, case studies can be used as inspiration to formulate theories and hypotheses, but those hypotheses and theories then need to be formally tested using more rigorous quantitative methods. The reason case studies shouldn’t be used to provide support for theories is that they suffer from problems with both internal and external validity. Case studies lack the proper controls that true experiments contain. As such, they suffer from problems with internal validity, so they cannot be used to determine causation. For instance, during HM’s surgery, the surgeon may have accidentally lesioned another area of HM’s brain (a possibility suggested by the dissection of HM’s brain following his death) and that lesion may have contributed to his inability to consolidate new information. The fact is, with case studies we cannot rule out these sorts of alternative explanations. So, as with all observational methods, case studies do not permit determination of causation. In addition, because case studies are often of a single individual, and typically an abnormal individual, researchers cannot generalize their conclusions to other individuals. Recall that with most research designs there is a trade-off between internal and external validity. With case studies, however, there are problems with both internal validity and external validity. So there are limits both to the ability to determine causation and to generalize the results. A final limitation of case studies is that ample opportunity exists for the theoretical biases of the researcher to color or bias the case description. Indeed, there have been accusations that the woman who studied HM destroyed a lot of her data that were not published and she has been called into question for destroying contradictory data that didn’t support her theory about how memories are consolidated. There is a fascinating New York Times article that describes some of the controversies that ensued after HM’s death and analysis of his brain that can be found at: https://www.nytimes.com/2016/08/07/magazine/the-brain-that-couldnt-remember.html?_r=0

Archival Research

Another approach that is often considered observational research involves analyzing archival data that have already been collected for some other purpose. An example is a study by Brett Pelham and his colleagues on “implicit egotism”—the tendency for people to prefer people, places, and things that are similar to themselves (Pelham, Carvallo, & Jones, 2005) [9] . In one study, they examined Social Security records to show that women with the names Virginia, Georgia, Louise, and Florence were especially likely to have moved to the states of Virginia, Georgia, Louisiana, and Florida, respectively.

As with naturalistic observation, measurement can be more or less straightforward when working with archival data. For example, counting the number of people named Virginia who live in various states based on Social Security records is relatively straightforward. But consider a study by Christopher Peterson and his colleagues on the relationship between optimism and health using data that had been collected many years before for a study on adult development (Peterson, Seligman, & Vaillant, 1988) [10] . In the 1940s, healthy male college students had completed an open-ended questionnaire about difficult wartime experiences. In the late 1980s, Peterson and his colleagues reviewed the men’s questionnaire responses to obtain a measure of explanatory style—their habitual ways of explaining bad events that happen to them. More pessimistic people tend to blame themselves and expect long-term negative consequences that affect many aspects of their lives, while more optimistic people tend to blame outside forces and expect limited negative consequences. To obtain a measure of explanatory style for each participant, the researchers used a procedure in which all negative events mentioned in the questionnaire responses, and any causal explanations for them were identified and written on index cards. These were given to a separate group of raters who rated each explanation in terms of three separate dimensions of optimism-pessimism. These ratings were then averaged to produce an explanatory style score for each participant. The researchers then assessed the statistical relationship between the men’s explanatory style as undergraduate students and archival measures of their health at approximately 60 years of age. The primary result was that the more optimistic the men were as undergraduate students, the healthier they were as older men. Pearson’s  r  was +.25.

This method is an example of  content analysis —a family of systematic approaches to measurement using complex archival data. Just as structured observation requires specifying the behaviors of interest and then noting them as they occur, content analysis requires specifying keywords, phrases, or ideas and then finding all occurrences of them in the data. These occurrences can then be counted, timed (e.g., the amount of time devoted to entertainment topics on the nightly news show), or analyzed in a variety of other ways.

Media Attributions

• What happens when you remove the hippocampus? – Sam Kean by TED-Ed licensed under a standard YouTube License
• Pappenheim 1882  by unknown is in the  Public Domain .
• Festinger, L., Riecken, H., & Schachter, S. (1956). When prophecy fails: A social and psychological study of a modern group that predicted the destruction of the world. University of Minnesota Press. ↵
• Rosenhan, D. L. (1973). On being sane in insane places. Science, 179 , 250–258. ↵
• Wilkins, A. (2008). “Happier than Non-Christians”: Collective emotions and symbolic boundaries among evangelical Christians. Social Psychology Quarterly, 71 , 281–301. ↵
• Levine, R. V., & Norenzayan, A. (1999). The pace of life in 31 countries. Journal of Cross-Cultural Psychology, 30 , 178–205. ↵
• Kraut, R. E., & Johnston, R. E. (1979). Social and emotional messages of smiling: An ethological approach. Journal of Personality and Social Psychology, 37 , 1539–1553. ↵
• Cohen, D., Nisbett, R. E., Bowdle, B. F., & Schwarz, N. (1996). Insult, aggression, and the southern culture of honor: An "experimental ethnography." Journal of Personality and Social Psychology, 70 (5), 945-960. ↵
• Watson, J. B., & Rayner, R. (1920). Conditioned emotional reactions. Journal of Experimental Psychology, 3 , 1–14. ↵
• Freud, S. (1961).  Five lectures on psycho-analysis . New York, NY: Norton. ↵
• Pelham, B. W., Carvallo, M., & Jones, J. T. (2005). Implicit egotism. Current Directions in Psychological Science, 14 , 106–110. ↵
• Peterson, C., Seligman, M. E. P., & Vaillant, G. E. (1988). Pessimistic explanatory style is a risk factor for physical illness: A thirty-five year longitudinal study. Journal of Personality and Social Psychology, 55 , 23–27. ↵

Research that is non-experimental because it focuses on recording systemic observations of behavior in a natural or laboratory setting without manipulating anything.

An observational method that involves observing people’s behavior in the environment in which it typically occurs.

When researchers engage in naturalistic observation by making their observations as unobtrusively as possible so that participants are not aware that they are being studied.

Where the participants are made aware of the researcher presence and monitoring of their behavior.

Refers to when a measure changes participants’ behavior.

In the case of undisguised naturalistic observation, it is a type of reactivity when people know they are being observed and studied, they may act differently than they normally would.

Researchers become active participants in the group or situation they are studying.

Researchers pretend to be members of the social group they are observing and conceal their true identity as researchers.

Researchers become a part of the group they are studying and they disclose their true identity as researchers to the group under investigation.

When a researcher makes careful observations of one or more specific behaviors in a particular setting that is more structured than the settings used in naturalistic or participant observation.

A part of structured observation whereby the observers use a clearly defined set of guidelines to "code" behaviors—assigning specific behaviors they are observing to a category—and count the number of times or the duration that the behavior occurs.

An in-depth examination of an individual.

A family of systematic approaches to measurement using qualitative methods to analyze complex archival data.

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How to Write a Great Hypothesis

Hypothesis Definition, Format, Examples, and Tips

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Amy Morin, LCSW, is a psychotherapist and international bestselling author. Her books, including "13 Things Mentally Strong People Don't Do," have been translated into more than 40 languages. Her TEDx talk,  "The Secret of Becoming Mentally Strong," is one of the most viewed talks of all time.

Verywell / Alex Dos Diaz

• The Scientific Method

Hypothesis Format

Falsifiability of a hypothesis.

• Operationalization

Hypothesis Types

Hypotheses examples.

• Collecting Data

A hypothesis is a tentative statement about the relationship between two or more variables. It is a specific, testable prediction about what you expect to happen in a study. It is a preliminary answer to your question that helps guide the research process.

Consider a study designed to examine the relationship between sleep deprivation and test performance. The hypothesis might be: "This study is designed to assess the hypothesis that sleep-deprived people will perform worse on a test than individuals who are not sleep-deprived."

At a Glance

A hypothesis is crucial to scientific research because it offers a clear direction for what the researchers are looking to find. This allows them to design experiments to test their predictions and add to our scientific knowledge about the world. This article explores how a hypothesis is used in psychology research, how to write a good hypothesis, and the different types of hypotheses you might use.

The Hypothesis in the Scientific Method

In the scientific method , whether it involves research in psychology, biology, or some other area, a hypothesis represents what the researchers think will happen in an experiment. The scientific method involves the following steps:

• Forming a question
• Performing background research
• Creating a hypothesis
• Designing an experiment
• Collecting data
• Analyzing the results
• Drawing conclusions
• Communicating the results

The hypothesis is a prediction, but it involves more than a guess. Most of the time, the hypothesis begins with a question which is then explored through background research. At this point, researchers then begin to develop a testable hypothesis.

Unless you are creating an exploratory study, your hypothesis should always explain what you  expect  to happen.

In a study exploring the effects of a particular drug, the hypothesis might be that researchers expect the drug to have some type of effect on the symptoms of a specific illness. In psychology, the hypothesis might focus on how a certain aspect of the environment might influence a particular behavior.

Remember, a hypothesis does not have to be correct. While the hypothesis predicts what the researchers expect to see, the goal of the research is to determine whether this guess is right or wrong. When conducting an experiment, researchers might explore numerous factors to determine which ones might contribute to the ultimate outcome.

In many cases, researchers may find that the results of an experiment  do not  support the original hypothesis. When writing up these results, the researchers might suggest other options that should be explored in future studies.

In many cases, researchers might draw a hypothesis from a specific theory or build on previous research. For example, prior research has shown that stress can impact the immune system. So a researcher might hypothesize: "People with high-stress levels will be more likely to contract a common cold after being exposed to the virus than people who have low-stress levels."

In other instances, researchers might look at commonly held beliefs or folk wisdom. "Birds of a feather flock together" is one example of folk adage that a psychologist might try to investigate. The researcher might pose a specific hypothesis that "People tend to select romantic partners who are similar to them in interests and educational level."

Elements of a Good Hypothesis

So how do you write a good hypothesis? When trying to come up with a hypothesis for your research or experiments, ask yourself the following questions:

• Is your hypothesis based on your research on a topic?
• Can your hypothesis be tested?
• Does your hypothesis include independent and dependent variables?

Before you come up with a specific hypothesis, spend some time doing background research. Once you have completed a literature review, start thinking about potential questions you still have. Pay attention to the discussion section in the  journal articles you read . Many authors will suggest questions that still need to be explored.

How to Formulate a Good Hypothesis

To form a hypothesis, you should take these steps:

• Collect as many observations about a topic or problem as you can.
• Evaluate these observations and look for possible causes of the problem.
• Create a list of possible explanations that you might want to explore.
• After you have developed some possible hypotheses, think of ways that you could confirm or disprove each hypothesis through experimentation. This is known as falsifiability.

In the scientific method ,  falsifiability is an important part of any valid hypothesis. In order to test a claim scientifically, it must be possible that the claim could be proven false.

Students sometimes confuse the idea of falsifiability with the idea that it means that something is false, which is not the case. What falsifiability means is that  if  something was false, then it is possible to demonstrate that it is false.

One of the hallmarks of pseudoscience is that it makes claims that cannot be refuted or proven false.

The Importance of Operational Definitions

A variable is a factor or element that can be changed and manipulated in ways that are observable and measurable. However, the researcher must also define how the variable will be manipulated and measured in the study.

Operational definitions are specific definitions for all relevant factors in a study. This process helps make vague or ambiguous concepts detailed and measurable.

For example, a researcher might operationally define the variable " test anxiety " as the results of a self-report measure of anxiety experienced during an exam. A "study habits" variable might be defined by the amount of studying that actually occurs as measured by time.

These precise descriptions are important because many things can be measured in various ways. Clearly defining these variables and how they are measured helps ensure that other researchers can replicate your results.

Replicability

One of the basic principles of any type of scientific research is that the results must be replicable.

Replication means repeating an experiment in the same way to produce the same results. By clearly detailing the specifics of how the variables were measured and manipulated, other researchers can better understand the results and repeat the study if needed.

Some variables are more difficult than others to define. For example, how would you operationally define a variable such as aggression ? For obvious ethical reasons, researchers cannot create a situation in which a person behaves aggressively toward others.

To measure this variable, the researcher must devise a measurement that assesses aggressive behavior without harming others. The researcher might utilize a simulated task to measure aggressiveness in this situation.

Hypothesis Checklist

• Does your hypothesis focus on something that you can actually test?
• Does your hypothesis include both an independent and dependent variable?
• Can you manipulate the variables?
• Can your hypothesis be tested without violating ethical standards?

The hypothesis you use will depend on what you are investigating and hoping to find. Some of the main types of hypotheses that you might use include:

• Simple hypothesis : This type of hypothesis suggests there is a relationship between one independent variable and one dependent variable.
• Complex hypothesis : This type suggests a relationship between three or more variables, such as two independent and dependent variables.
• Null hypothesis : This hypothesis suggests no relationship exists between two or more variables.
• Alternative hypothesis : This hypothesis states the opposite of the null hypothesis.
• Statistical hypothesis : This hypothesis uses statistical analysis to evaluate a representative population sample and then generalizes the findings to the larger group.
• Logical hypothesis : This hypothesis assumes a relationship between variables without collecting data or evidence.

A hypothesis often follows a basic format of "If {this happens} then {this will happen}." One way to structure your hypothesis is to describe what will happen to the  dependent variable  if you change the  independent variable .

The basic format might be: "If {these changes are made to a certain independent variable}, then we will observe {a change in a specific dependent variable}."

A few examples of simple hypotheses:

• "Students who eat breakfast will perform better on a math exam than students who do not eat breakfast."
• "Students who experience test anxiety before an English exam will get lower scores than students who do not experience test anxiety."​
• "Motorists who talk on the phone while driving will be more likely to make errors on a driving course than those who do not talk on the phone."
• "Children who receive a new reading intervention will have higher reading scores than students who do not receive the intervention."

Examples of a complex hypothesis include:

• "People with high-sugar diets and sedentary activity levels are more likely to develop depression."
• "Younger people who are regularly exposed to green, outdoor areas have better subjective well-being than older adults who have limited exposure to green spaces."

Examples of a null hypothesis include:

• "There is no difference in anxiety levels between people who take St. John's wort supplements and those who do not."
• "There is no difference in scores on a memory recall task between children and adults."
• "There is no difference in aggression levels between children who play first-person shooter games and those who do not."

Examples of an alternative hypothesis:

• "People who take St. John's wort supplements will have less anxiety than those who do not."
• "Adults will perform better on a memory task than children."
• "Children who play first-person shooter games will show higher levels of aggression than children who do not." 

Collecting Data on Your Hypothesis

Once a researcher has formed a testable hypothesis, the next step is to select a research design and start collecting data. The research method depends largely on exactly what they are studying. There are two basic types of research methods: descriptive research and experimental research.

Descriptive Research Methods

Descriptive research such as  case studies ,  naturalistic observations , and surveys are often used when  conducting an experiment is difficult or impossible. These methods are best used to describe different aspects of a behavior or psychological phenomenon.

Once a researcher has collected data using descriptive methods, a  correlational study  can examine how the variables are related. This research method might be used to investigate a hypothesis that is difficult to test experimentally.

Experimental Research Methods

Experimental methods  are used to demonstrate causal relationships between variables. In an experiment, the researcher systematically manipulates a variable of interest (known as the independent variable) and measures the effect on another variable (known as the dependent variable).

Unlike correlational studies, which can only be used to determine if there is a relationship between two variables, experimental methods can be used to determine the actual nature of the relationship—whether changes in one variable actually  cause  another to change.

The hypothesis is a critical part of any scientific exploration. It represents what researchers expect to find in a study or experiment. In situations where the hypothesis is unsupported by the research, the research still has value. Such research helps us better understand how different aspects of the natural world relate to one another. It also helps us develop new hypotheses that can then be tested in the future.

Thompson WH, Skau S. On the scope of scientific hypotheses .  R Soc Open Sci . 2023;10(8):230607. doi:10.1098/rsos.230607

Taran S, Adhikari NKJ, Fan E. Falsifiability in medicine: what clinicians can learn from Karl Popper [published correction appears in Intensive Care Med. 2021 Jun 17;:].  Intensive Care Med . 2021;47(9):1054-1056. doi:10.1007/s00134-021-06432-z

Eyler AA. Research Methods for Public Health . 1st ed. Springer Publishing Company; 2020. doi:10.1891/9780826182067.0004

Nosek BA, Errington TM. What is replication ?  PLoS Biol . 2020;18(3):e3000691. doi:10.1371/journal.pbio.3000691

Aggarwal R, Ranganathan P. Study designs: Part 2 - Descriptive studies .  Perspect Clin Res . 2019;10(1):34-36. doi:10.4103/picr.PICR_154_18

Nevid J. Psychology: Concepts and Applications. Wadworth, 2013.

By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

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• Knowledge Base
• Methodology
• What Is an Observational Study? | Guide & Examples

What Is an Observational Study? | Guide & Examples

Published on 5 April 2022 by Tegan George . Revised on 20 March 2023.

An observational study is used to answer a research question based purely on what the researcher observes. There is no interference or manipulation of the research subjects, and no control and treatment groups .

These studies are often qualitative in nature and can be used for both exploratory and explanatory research purposes. While quantitative observational studies exist, they are less common.

Observational studies are generally used in hard science, medical, and social science fields. This is often due to ethical or practical concerns that prevent the researcher from conducting a traditional experiment . However, the lack of control and treatment groups means that forming inferences is difficult, and there is a risk of confounding variables impacting your analysis.

Table of contents

Types of observation, types of observational studies, observational study example, advantages and disadvantages of observational studies, observational study vs experiment, frequently asked questions.

There are many types of observation, and it can be challenging to tell the difference between them. Here are some of the most common types to help you choose the best one for your observational study.

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There are three main types of observational studies: cohort studies, case–control studies, and cross-sectional studies.

Cohort studies

Cohort studies are more longitudinal in nature, as they follow a group of participants over a period of time. Members of the cohort are selected because of a shared characteristic, such as smoking, and they are often observed over a period of years.

Case–control studies

Case–control studies bring together two groups, a case study group and a control group . The case study group has a particular attribute while the control group does not. The two groups are then compared, to see if the case group exhibits a particular characteristic more than the control group.

For example, if you compared smokers (the case study group) with non-smokers (the control group), you could observe whether the smokers had more instances of lung disease than the non-smokers.

Cross-sectional studies

Cross-sectional studies analyse a population of study at a specific point in time.

This often involves narrowing previously collected data to one point in time to test the prevalence of a theory—for example, analysing how many people were diagnosed with lung disease in March of a given year. It can also be a one-time observation, such as spending one day in the lung disease wing of a hospital.

Observational studies are usually quite straightforward to design and conduct. Sometimes all you need is a notebook and pen! As you design your study, you can follow these steps.

Step 1: Identify your research topic and objectives

The first step is to determine what you’re interested in observing and why. Observational studies are a great fit if you are unable to do an experiment for ethical or practical reasons, or if your research topic hinges on natural behaviors.

Step 2: Choose your observation type and technique

In terms of technique, there are a few things to consider:

• Are you determining what you want to observe beforehand, or going in open-minded?
• Is there another research method that would make sense in tandem with an observational study?
• If yes, make sure you conduct a covert observation.
• If not, think about whether observing from afar or actively participating in your observation is a better fit.
• How can you preempt confounding variables that could impact your analysis?
• You could observe the children playing at the playground in a naturalistic observation.
• You could spend a month at a day care in your town conducting participant observation, immersing yourself in the day-to-day life of the children.
• You could conduct covert observation behind a wall or glass, where the children can’t see you.

Overall, it is crucial to stay organised. Devise a shorthand for your notes, or perhaps design templates that you can fill in. Since these observations occur in real time, you won’t get a second chance with the same data.

Step 3: Set up your observational study

Before conducting your observations, there are a few things to attend to:

• Plan ahead: If you’re interested in day cares, you’ll need to call a few in your area to plan a visit. They may not all allow observation, or consent from parents may be needed, so give yourself enough time to set everything up.
• Determine your note-taking method: Observational studies often rely on note-taking because other methods, like video or audio recording, run the risk of changing participant behavior.
• Get informed consent from your participants (or their parents) if you want to record:  Ultimately, even though it may make your analysis easier, the challenges posed by recording participants often make pen-and-paper a better choice.

Step 4: Conduct your observation

After you’ve chosen a type of observation, decided on your technique, and chosen a time and place, it’s time to conduct your observation.

Here, you can split them into case and control groups. The children with siblings have a characteristic you are interested in (siblings), while the children in the control group do not.

When conducting observational studies, be very careful of confounding or ‘lurking’ variables. In the example above, you observed children as they were dropped off, gauging whether or not they were upset. However, there are a variety of other factors that could be at play here (e.g., illness).

Step 5: Analyse your data

After you finish your observation, immediately record your initial thoughts and impressions, as well as follow-up questions or any issues you perceived during the observation. If you audio- or video-recorded your observations, you can transcribe them.

Your analysis can take an inductive or deductive approach :

• If you conducted your observations in a more open-ended way, an inductive approach allows your data to determine your themes.
• If you had specific hypotheses prior to conducting your observations, a deductive approach analyses whether your data confirm those themes or ideas you had previously.

Next, you can conduct your thematic or content analysis . Due to the open-ended nature of observational studies, the best fit is likely thematic analysis.

Step 6: Discuss avenues for future research

Observational studies are generally exploratory in nature, and they often aren’t strong enough to yield standalone conclusions due to their very high susceptibility to observer bias and confounding variables. For this reason, observational studies can only show association, not causation .

If you are excited about the preliminary conclusions you’ve drawn and wish to proceed with your topic, you may need to change to a different research method , such as an experiment.

• Observational studies can provide information about difficult-to-analyse topics in a low-cost, efficient manner.
• They allow you to study subjects that cannot be randomised safely, efficiently, or ethically .
• They are often quite straightforward to conduct, since you just observe participant behavior as it happens or utilise preexisting data.
• They’re often invaluable in informing later, larger-scale clinical trials or experiments.

Disadvantages

• Observational studies struggle to stand on their own as a reliable research method. There is a high risk of observer bias and undetected confounding variables.
• They lack conclusive results, typically are not externally valid or generalisable, and can usually only form a basis for further research.
• They cannot make statements about the safety or efficacy of the intervention or treatment they study, only observe reactions to it. Therefore, they offer less satisfying results than other methods.

The key difference between observational studies and experiments is that a properly conducted observational study will never attempt to influence responses, while experimental designs by definition have some sort of treatment condition applied to a portion of participants.

However, there may be times when it’s impossible, dangerous, or impractical to influence the behavior of your participants. This can be the case in medical studies, where it is unethical or cruel to withhold potentially life-saving intervention, or in longitudinal analyses where you don’t have the ability to follow your group over the course of their lifetime.

An observational study may be the right fit for your research if random assignment of participants to control and treatment groups is impossible or highly difficult. However, the issues observational studies raise in terms of validity , confounding variables, and conclusiveness can mean that an experiment is more reliable.

If you’re able to randomise your participants safely and your research question is definitely causal in nature, consider using an experiment.

An observational study could be a good fit for your research if your research question is based on things you observe. If you have ethical, logistical, or practical concerns that make an experimental design challenging, consider an observational study. Remember that in an observational study, it is critical that there be no interference or manipulation of the research subjects. Since it’s not an experiment, there are no control or treatment groups either.

The key difference between observational studies and experiments is that, done correctly, an observational study will never influence the responses or behaviours of participants. Experimental designs will have a treatment condition applied to at least a portion of participants.

Exploratory research explores the main aspects of a new or barely researched question.

Explanatory research explains the causes and effects of an already widely researched question.

The research methods you use depend on the type of data you need to answer your research question .

• If you want to measure something or test a hypothesis , use quantitative methods . If you want to explore ideas, thoughts, and meanings, use qualitative methods .
• If you want to analyse a large amount of readily available data, use secondary data. If you want data specific to your purposes with control over how they are generated, collect primary data.
• If you want to establish cause-and-effect relationships between variables , use experimental methods. If you want to understand the characteristics of a research subject, use descriptive methods.

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• Published: 15 May 2024

Association between pediatric postoperative delirium and regional cerebral oxygen saturation: a prospective observational study

• Kexian Liu 1 , 3   na1 ,
• Nan Lin 1 , 2   na1 ,
• Ting Jin 1 ,
• Yujun Xiang 1 ,
• Jiahuan Li 1 ,
• Dengming Lai 2 &
• Hongzhen Xu 1  

BMC Psychiatry volume  24 , Article number:  367 ( 2024 ) Cite this article

Metrics details

Postoperative delirium (POD) represents a prevalent and noteworthy complication in the context of pediatric surgical interventions. In recent times, a hypothesis has emerged positing that cerebral ischemia and regional cerebral oxygen desaturation might serve as potential catalysts in the pathogenesis of POD. The primary aim of this study was to methodically examine the potential relationship between POD and regional cerebral oxygen saturation (rSO 2 ) and to assess the predictive and evaluative utility of rSO 2 in the context of POD.

This prospective observational study was conducted at the Children’s Hospital, Zhejiang University School of Medicine, Zhejiang, China, spanning the period from November 2020 to March 2021. The research cohort comprised children undergoing surgical procedures within this clinical setting. To measure rSO 2 dynamics, cerebral near-infrared spectroscopy (NIRS) was used to monitor rSO 2 levels both before and after surgery. In addition, POD was assessed in the paediatric patients according to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) criteria. The analysis of the association between the rSO 2 index and the incidence of POD was carried out through the application of either the independent samples t-test or the nonparametric rank-sum test. To ascertain the threshold value of the adjusted rSO 2 index for predictive and evaluative purposes regarding POD in the pediatric population, the Receiver Operating Characteristics (ROC) curve was employed.

A total of 211 cases were included in this study, of which 61 (28.9%) developed POD. Participants suffering delirium had lower preoperative rSO 2 mean, lower preoperative rSO 2min , and lower postoperative rSO 2min , higher ∆rSO 2mean , higher amount of ∆rSO 2mean , lower ∆rSO 2min ( P  < 0.05). Preoperative rSO 2mean (AUC = 0.716, 95%CI 0.642–0.790), ∆rSO 2mean (AUC = 0.694, 95%CI 0.614–0.774), amount of ∆rSO 2mean (AUC = 0.649, 95%CI 0.564–0.734), preoperative rSO 2min (AUC = 0.702, 96%CI 0.628–0.777), postoperative rSO 2min (AUC = 0.717, 95%CI 0.647–0.787), and ∆rSO 2min (AUC = 0.714, 95%CI 0.638–0.790) performed well in sensitivity and specificity, and the best threshold were 62.05%, 1.27%, 2.41%, 55.68%, 57.36%, 1.29%.

Conclusions

There is a close relationship between pediatric POD and rSO 2 . rSO 2 could be used as an effective predictor of pediatric POD. It might be helpful to measure rSO 2 with NIRS for early recognizing POD and making it possible for early intervention.

1. Pediatric postoperative delirium is closely related to rSO2.

2. Incorporating rSO2 monitoring into pediatric perioperative nursing plans and procedures could be effective, especially in younger children.

3. Further investigation can focus on different approaches to optimize perioperative cerebral oxygenation.

4. This study provides a new idea for the prediction, identification and evaluation of postoperative delirium in children, and helps to improve the objectivity, accuracy and effectiveness of evaluation.

Peer Review reports

Introduction

Postoperative delirium (POD) in pediatric patients is a common, transient complication following general anesthesia, characterized by fluctuating states of confusion during the post-anesthetic recovery phase [ 1 ]. Studies indicate a high incidence, with rates up to 66%, highlighting its significance in pediatric care [ 2 , 3 ]. The inflammatory response to surgery contributes to cognitive deterioration [ 4 ], underscoring the risk of adverse events such as falls and unplanned extubation, which can extend hospital stays and increase healthcare costs [ 5 , 6 ].

Recent advances in objective assessment tools for POD include glucose metabolism evaluation via positron emission tomography (PET) [ 7 ], neuroimaging techniques [ 8 ], and electroencephalography (EEG) [ 9 ]. Despite their potential, the implementation of such tools, especially EEG, in clinical settings remains inconsistent, reflecting the need for more reliable indicators tailored for pediatric patients.

In this context, Near-Infrared Spectroscopy (NIRS) has emerged as a crucial tool in this context, offering non-invasive monitoring of perioperative cerebral oxygenation [ 10 , 11 ]. By analyzing the interaction of light with cerebral hemoglobins, NIRS provides real-time insights into brain oxygenation status, potentially linking cerebral tissue hypoperfusion and hypoxia to POD [ 12 ]. Recent studies have initiated investigations into the relationship between rSO 2 and POD, indicating that perioperative rSO 2 monitoring holds promise in the prediction, assessment, and identification of POD [ 11 , 13 ]. Nevertheless, it is noteworthy that existing research is primarily focused on adult patients, with POD being more prevalent among elderly patients and those undergoing cardiac surgery, among other factors [ 11 ]. The specific relationship between perioperative rSO 2 and POD in children following general surgery remains an area requiring thorough exploration.

Our study seeks to fill this gap by investigating rSO 2 ’s potential as a predictive and diagnostic marker for POD in pediatric patients undergoing general anesthesia. We hypothesize that rSO 2 can serve as a reflective indicator of POD, potentially improving the anticipation and management of this condition. By providing healthcare professionals with a reliable tool for anticipating and managing POD, we aim to enhance patient safety and care outcomes.

Study design and population

This study was carried out as a prospective observational study, focusing on pediatric patients who were hospitalized and in need of surgical treatment. The study cohort was recruited from Children’s Hospital, Zhejiang University School of Medicine, during the period spanning from November 2020 to March 2021. Exclusion criteria were applied to individuals meeting any of the following conditions: (a) the presence of factors that could potentially affect the assessment of delirium, such as severe cognitive impairment, coma, or deep sedation, (b) significant visual or hearing impairments that hindered the assessment of delirium, (c) participation in concurrent research endeavors involving new drugs or treatments, and (d) age falling below 1 year or exceeding 16 years. This study received approval from the Ethics Committee of Children’s Hospital, Zhejiang University School of Medicine on January 23, 2020, with the reference number 2020-IRB-001. In adherence to ethical standards, written informed consent was obtained from the parents of all participating children. Additionally, children who were 8 years of age or older provided their informed consent through a form specially designed for their age group.

Study endpoints and power calculation

The endpoint for this study was the occurrence of postoperative delirium. The primary outcome measures were the predictive values of rSO 2 values for delirium following surgery in pediatric patients. A sample size calculation was performed under the assumption that rSO 2 could predict or identify the occurrence of postoperative delirium. Based on a previous study, the expected sensitivity and specificity were set at 91.67% and 79.31% respectively [ 14 ]. If the tolerance was set at 0.08, significance level at 0.05, according to the equation below, we needed 145 patients. Considering a 15% of follow-up loss, 167 patients were enrolled.

Sample size (n) based on sensitivity:

Sample size (n) based on specificity:

p 1 = estimated sensitivity, p 2 = estimated specificity, μ α = the value of μ in the normal distribution when the cumulative probability is equal to α /2, δ  = tolerance (the value is generally 0.1 or 0.08).

Anesthesia and postoperative pain management

For the administration of anesthesia and the management of postoperative pain, this study adhered to the established Standard Operating Procedures (SOPs) of Children’s Hospital, Zhejiang University School of Medicine, which are detailed in the Supplementary File. These SOPs are standardized to ensure consistency and ethical management of pediatric anesthesia and pain across different surgical procedures.

Diagnosis of POD

The assessment of POD commenced immediately after the children regained consciousness following surgery. Evaluations were conducted every half hour over a 2-h period by a qualified psychiatrist. The DSM-5, considered the gold standard for identifying delirium, outlines several criteria for the diagnosis, including disturbances in attention, awareness, and cognition. These disturbances are not attributable to preexisting, established, or evolving neurocognitive disorders and represent a change from baseline attention and awareness. To diagnose POD, the psychiatrist specifically looked for acute onset and fluctuating levels of these disturbances, as observed through clinical assessment during the recovery phase. This method ensures sensitivity to the dynamic nature of delirium, where symptoms may come and go or increase in intensity throughout the observation period. Evaluations focused on the ability to direct, focus, sustain, and shift attention, and on the overall level of consciousness, which might range from hyperalertness to lethargy or stupor. To ensure the accuracy of the assessments, the psychiatrist remained in close proximity to the child throughout the evaluation period, minimizing the risk of overlooking any instances of delirium. This proximity allowed for immediate response and adjustment of the clinical assessment based on the child’s moment-to-moment changes in cognitive and perceptual disturbances. The psychiatrist’s assessments were detailed and recorded systematically to ensure that any occurrence of POD was captured accurately, providing a robust dataset for analysis and future reference.

Monitoring of rSO 2

The rSO 2 was monitored using the NIRS (EGOS-600A, Aiqin, Suzhou, China). The rSO 2 probes were placed on each children’s forehead and stabilized (single NIRS monitoring). Cerebral oxygen data were recorded every 2 s. We conducted rSO 2 monitoring the day before surgery and after surgery as soon as the children awakened. Each monitoring event required 2 h. rSO 2 (%) was calculated as follows: preoperative rSO 2 (the average value of preoperative rSO 2 detection values within 2 h); postoperative rSO 2 (the average value of postoperative rSO 2 detection values within 2 h); ∆rSO 2 (%) = postoperative rSO 2 –preoperative rSO 2 ; preoperative rSO 2min (the minimum preoperative rSO 2 in 2 h); postoperative rSO 2min (the minimum postoperative rSO 2 in 2 h); ∆rSO 2min (%) = postoperative rSO 2min –preoperative rSO 2min .

Data collection

The data collection encompassed a wide range of information, including (a) general demographics: age, gender, weight, height, body mass index (BMI), and BMI Z-score; (b) Past medical history, which included prior surgical procedures, history of trauma, allergies, and the presence of major medical conditions, including but not limited to tic disorders; (c) Surgical-specific details, such as ASA (American Society of Anesthesiologists) classification, the duration of preoperative fasting and water deprivation, specifics regarding the anesthesia and surgical procedures, the volume of fluids administered intraoperatively, medication use, intraoperative bleeding, intraoperative body temperature monitoring, postoperative pain assessment, administration of oxygen, and the placement of drainage tubes.

Statistical analysis

Means and standard deviations were used to summarized normally-distributed data, and medians and quartile ranges were used to summarize data with non-normal distributions. Univariate analyses (two-sample t test, Mann–Whitney U test, Pearson’s correlation, Spearman’s correlation) were performed to explore potential predictors and the correlation between rSO 2 and POD. Variables related to POD (at p  < 0.05) were used as predictors in multivariable logistic regression models. Variables related to rSO 2 (at p  < 0.05) were used as predictors in multivariable linear regression models and produced adjusted indicators of rSO 2 (rSO 2 indicators generated after correcting for confounders). The best cutoff values for the rSO 2 on POD were further determined by receiver operating characteristic (ROC) analysis. Statistical significance was assessed at the 5% level ( p  < 0.05 was assumed to be statistically significant).

General characteristics

A cohort of 211 pediatric participants were enrolled in the present study (Fig.  1 ). The median age of the cohort stood at 5 years, with a notable gender distribution, comprising 59.2% males. The majority of the pediatric subjects exhibited a Class I ASA physical status, with a prevalence of 85.8%. General anesthesia was administered to a substantial proportion of participants, employing tracheal intubation in 83.9% of cases. Noteworthy pharmaceutical agents employed during the surgical interventions included propofol and midazolam, each administered to all participants, as indicated in Table  1 . Importantly, no rescue interventions were necessitated during the course of the surgical procedures. The logistic regression analysis showed that age, postoperative pain, and postoperative oxygen therapy could explain 31.5% of the variance in postoperative delirium among pediatric patients (Table  2 ).

Flow chart for patient selection

Preoperative rSO 2 , postoperative rSO 2 and ∆rSO 2

The preoperative rSO 2 was quantified at (62.19 ± 2.55)%, with a median preoperative rSO 2min of 56.35% (53.22–58.48). Following the surgical procedure, postoperative rSO 2 levels were recorded as (64.02 ± 3.18)%, and the median postoperative rSO 2min was 58.09 (53.99–60.61)%. The ∆rSO 2 was (1.83 ± 3.35)%, with the median value of ∆rSO 2 amounting to 2.42% (1.00–4.49), and ∆rSO 2min was (1.19 ± 5.98)%. Tables 3 and 4 present the predictors associated with preoperative rSO 2 , postoperative rSO 2 , and ∆rSO 2 . In order to control for potential confounding factors, adjusted values for these three indicators were computed, taking into account variables such as age, the use of antiemetics, administration of dexmedetomidine, postoperative pain levels, and the provision of oxygen after surgery.

Correlation between POD and rSO 2

In the context of POD among children, all rSO 2 values demonstrated significant associations, with the exception of postoperative rSO 2 adjustments, which did not exhibit a statistically significant relationship with the occurrence of POD. Specifically, participants who experienced delirium following surgery displayed several noteworthy trends in their adjusted rSO 2 values. These included lower adjusted preoperative rSO 2 levels (z = -4.992, p  < 0.001), decreased adjusted preoperative rSO 2min (z = -4.606, p  < 0.001), reduced adjusted postoperative rSO 2min (z = -4.942, p  < 0.001), elevated adjusted ∆rSO 2 (z = -4.416, p  < 0.001), and diminished adjusted ∆rSO 2min (z = -4.865, p  < 0.001), as detailed in Table  5 .

The ROC analysis for rSO 2 on POD

Results of ROC analysis for rSO 2 on POD are shown in Fig.  2 . Adjusted preoperative rSO 2 (AUC = 0.716, 95%CI 0.642–0.790, p  < 0.001), ∆rSO 2 (AUC = 0.694, 95%CI 0.614–0.774, p  < 0.001), preoperative rSO 2min (AUC = 0.70 2 , 96%CI 0.628–0.777, p  < 0.001), postoperative rSO 2min (AUC = 0.717, 95%CI 0.647–0.787, p  < 0.001), and ∆rSO 2min (AUC = 0.714, 95%CI 0.638–0.790, p  < 0.001) performed well in sensitivity and specificity.

The ROC curves for rSO 2 on postoperative delirium

In our current study, we conducted a comprehensive follow-up of 211 pediatric surgery patients and identified that 28.9% of them developed POD, as diagnosed in accordance with the DSM-5 criteria. Based on our initial hypothesis suggesting a close association between regional cerebral oxygen saturation (rSO2) and the occurrence of POD, we systematically monitored both preoperative and postoperative rSO2 levels in our cohort of patients. Through our investigation, we successfully validated the strong relationship between preoperative and postoperative rSO2 and the development of POD. Furthermore, our study revealed predictive values of rSO2 that can serve as valuable indicators for assessing the likelihood of POD.

Utilizing NIRS to assess rSO 2 , our study observed that the mean rSO 2 values in our participant cohort fell within the normal range (preoperative rSO 2  = 62.19, SD = 2.55; postoperative rSO 2  = 64.02, SD = 3.18), as stipulated within the reported range of 60%-70% [ 15 , 16 ]. Furthermore, our investigation identified age as the most influential predictor of both preoperative and postoperative rSO 2 levels. Specifically, older children displayed higher preoperative rSO 2 , increased preoperative rSO 2min , and elevated postoperative rSO 2 values. This phenomenon can be attributed to the rapid developmental changes occurring in the pediatric brain, leading to heightened cerebral blood flow compared to adults [ 17 ]. Interestingly, this finding aligns with a prior study involving children aged 7–13 years, which also reported age as a positive predictor of cerebral oxygenation [ 18 ]. However, it contrasts with some studies in adults that have shown a negative correlation between age and rSO 2 [ 19 ]. This discrepancy may be attributed to the fundamental differences in brain physiology between adults and children, which results in distinct age-related patterns of rSO 2 , emphasizing the importance of considering age as a significant factor in pediatric studies. In addition to age, our study identified postoperative pain, administration of postoperative oxygen, and the utilization of specific medications as significant predictive factors for postoperative rSO 2 . Notably, the provision of postoperative oxygen exhibited a positive effect, leading to an increase in both postoperative rSO 2 and ∆rSO 2 levels. This observation suggests that the postoperative rSO 2 tends to surpass the preoperative rSO 2 , which may be attributed to intraoperative ventilation practices or the administration of high oxygen concentrations. Moreover, our study revealed that postoperative rSO 2min and ∆rSO 2min values were notably lower in children who received oxygenation following surgery. This implies that the actual postoperative rSO 2 levels in the oxygenated group were inferior to those in the non-oxygenated group. The decrease in postoperative rSO 2min and ∆rSO 2min associated with postoperative pain aligns with findings from previous studies, likely attributable to the established link between pain and reduced cerebral blood flow [ 20 , 21 ].

Certain medications have been found to influence postoperative rSO 2 , including dexmedetomidine and antiemetics. Dexmedetomidine is known to effectively reduce postoperative agitation in pediatric patients undergoing general anesthesia, which is why it is commonly used as a preventive measure against POD [ 22 ]. However, our study revealed that children who received dexmedetomidine exhibited lower postoperative rSO 2min . One possible explanation for this observation is that dexmedetomidine, which can pass through the blood–brain barrier, exerts a central anti-sympathetic effect, inhibiting the release of catecholamines, thereby reducing blood pressure and slowing heart rate [ 23 ]. In our research, the use of antiemetics (ondansetron) was associated with higher postoperative rSO 2 and ∆rSO 2 . This association may be attributed to the intravenous administration of ondansetron, which helps maintain hemodynamic stability. This, in turn, can reduce the incidence of post-anesthetic hypotension, bradycardia, and tremors.

Given the intricate interplay of confounding factors affecting rSO 2 , our study employed multiple linear regression to calculate adjusted rSO 2 indicators. Subsequently, we conducted an analysis to explore the relationship between rSO 2 and the occurrence of POD. Our investigation identified five rSO 2 indicators that demonstrated strong predictive capability for POD, encompassing both adjusted and unadjusted parameters. Primarily, our study unveiled a substantial influence of preoperative rSO 2 on the likelihood of POD, particularly highlighting the significance of smaller values in the context of adjusted preoperative rSO 2 and adjusted preoperative rSO 2min . This observation underscores the critical importance of preoperative rSO 2 measurements. It’s worth noting that various researchers have proposed the concept of cognitive reserve, and building upon this idea, Julika and colleagues [ 24 ] have suggested that rSO 2 could be viewed as a physical marker of cognitive reserve. In the context of our study, the lower preoperative rSO 2 levels observed in children who subsequently developed POD may be indicative of heightened susceptibility to cerebral impairment. When compared to prior findings in adult populations, our study revealed a superior predictive value of adjusted preoperative rSO 2 , with a threshold of less than 62.05%. This value is notably higher than the reported threshold of less than 59.5% in adults [ 25 ]. This discrepancy may be attributed to the fundamental physiological distinctions between adults and children. Collectively, our findings underscore the critical importance of monitoring preoperative rSO 2 in pediatric surgical cases. Specifically, if the preoperative mean rSO 2 falls below 62.05% or the minimum rSO 2 is less than 55.68%, heightened vigilance for the potential development of POD is warranted.

Furthermore, our analysis revealed that diminished values of the adjusted postoperative rSO 2min were predictive of POD, with a threshold set at 57.36%. Although establishing a causal relationship between low postoperative rSO 2 and the subsequent occurrence of POD posed challenges, the clear correlation between decreased postoperative rSO 2min and the presence of POD underscores the critical need for healthcare providers to exercise enhanced vigilance when attending to pediatric patients displaying lower postoperative rSO 2min values. In addition, our investigation indicated that elevated values of the adjusted ∆rSO 2 and reduced values of the adjusted ∆rSO 2min were associated with an increased likelihood of POD. In our study, adjusted ∆rSO 2 values exceeding 1.27% and adjusted ∆rSO 2min values below 1.29% were indicative of a heightened risk of POD. It is essential to acknowledge that ∆rSO 2 values can be influenced by subtle factors such as sensor positioning, scattering, and variations in the path length of the detected light beam. Consequently, further research is warranted to confirm the association between ∆rSO 2 and POD.

Implications for clinical practice

This study reveals the potential of rSO2 as an indicator for postoperative delirium (POD) in children, suggesting that perioperative monitoring of cerebral oxygen saturation could be crucial for early detection and intervention. The implementation of rSO2 monitoring could enable healthcare providers to identify patients at risk of POD, potentially leading to tailored care strategies that improve postoperative recovery. Future research should aim to define rSO2 thresholds for intervention and evaluate the effectiveness of such measures in reducing POD. Our findings advocate for a paradigm shift in perioperative care, emphasizing cerebral oxygenation as a key factor in pediatric anesthesia management.

Limitations

Several limitations should be considered in the context of this study. Firstly, the exclusive recruitment of children from a single medical center may limit the generalizability of the findings. Secondly, it’s important to acknowledge that the predictors examined in this study only accounted for a portion of the variance in rSO2. To obtain a more comprehensive understanding, further investigations are in the planning stages to address this issue in greater detail. Thirdly, our study did not delve into the prediction of postoperative delirium by rSO2 within specific age groups. Subsequent research should aim to establish rSO2 thresholds for predicting postoperative delirium in children of varying age brackets. Moreover, it is essential to recognize that confounding variables were not entirely controlled for, owing to certain clinical constraints. Additionally, the study was hindered by insufficient intraoperative monitoring of the children’s condition. We also acknowledge the absence of comprehensive electrolyte monitoring as a significant limitation, which could have provided additional insights into the perioperative physiological changes affecting our patients. Finally, it’s important to note that delirium episodes occurring more than 2 h after surgery were not considered in this study, as the pediatric patients generally exhibited mild conditions and rapid postoperative recovery. Additionally, the heterogeneity in anesthesia and analgesia protocols might have influenced the study outcomes related to POD. Although we meticulously incorporated various anesthesia-related factors into our analysis, the variability in these protocols could pose a challenge to the consistency of our results, which we plan to address more thoroughly in future research.

In conclusion, our study underscores the potential of rSO 2 , as measured by NIRS, as a valuable predictor of pediatric POD. However, it is crucial to emphasize that further validation through large-scale, multi-center studies is essential to solidify this relationship. In terms of prevention and treatment, interventions should be tailored to optimize perioperative cerebral oxygenation through various approaches, including the optimization of oxygen content, hemoglobin levels, and hemodynamic status.

Availability of data and materials

The datasets used during the current study available from the corresponding author on reasonable request.

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Supported by Foundation for the Medical and Health Research Project of Zhejiang Province, (2021KY187), (2022KY194).

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Kexian Liu and Nan Lin contributed equally to this work and should be considered joint first author.

Authors and Affiliations

Nursing Department, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, 310052, China

Kexian Liu, Nan Lin, Ting Jin, Yujun Xiang, Jiahuan Li & Hongzhen Xu

Department of Neonatal Surgery, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, 310052, China

Nan Lin & Dengming Lai

Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China

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Study design: K.L., N.L., D.L., H.X. Data collection: K.L., N.L., T.J., D.L. Data analysis: K.L., N.L. Study supervision: H.X., D.L. Manuscript writing: N.L., K.L. Funding acquisition: H.X. Critical revisions for important intellectual content: N.L., T.J., Y.X., J.L., D.L., H.X.

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Correspondence to Dengming Lai or Hongzhen Xu .

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Liu, K., Lin, N., Jin, T. et al. Association between pediatric postoperative delirium and regional cerebral oxygen saturation: a prospective observational study. BMC Psychiatry 24 , 367 (2024). https://doi.org/10.1186/s12888-024-05832-x

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DOI : https://doi.org/10.1186/s12888-024-05832-x

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Digitization of cultural heritage information resources for effective utilization in south-east nigeria, kate nkechinyere ogbu, ejike udensi igwebuike.

This study examines the level of digitization and integration of ICT in the preservation and management of cultural information resources for effective utilization in cultural heritage institutions in South-East, Nigeria. A descriptive survey research design was used for the study. The population of the study is 453 consisting of all the staff of public libraries and museums in South-East, Nigeria. The researchers used an observation checklist and a questionnaire for data collection. The data collected were analyzed using mean and standard deviations. Also T-test was used for the hypothesis. The findings of the study revealed that there is a very low level of digitization of cultural resources in the south-east Nigeria and therefore recommended an urgent need for the digitization of cultural heritage information resources for effective utilization in cultural heritage institutions.

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