Suggest retrospective, unique research topics for an MBBS student. Surgery focused. The most common cases we see are perforated appendicitis, cholecystectomy and hernia. Make the list of topics brilliant, worthy of my time, feasible and easy to obtain data. I need to finish it within 20 days. It should be brilliant!
Reading File
Reading File
Searching PubMed
"perforated appendicitis" AND "retrospective"
Searching PubMed
"cholecystectomy" AND "difficult" AND "predictors"
Searching PubMed
"hernia, inguinal" AND "emergency" AND "outcomes"
I'd pick Topic 1 (the delay decomposition in perforated appendicitis) or Topic 4 (what happens while patients wait for cholecystectomy). Both ask a question your own hospital has to answer, and the data is already in the files. The topics below are ranked by value for your time.
A quick PubMed check shows which angles are crowded:
- Models predicting perforated appendicitis are everywhere (2026 rule-in model, 2024 nomogram, 2023 score). Don't build another one. Validate an existing one locally instead (Topic 3).
- The 2025 EAST guideline on incarcerated and strangulated inguinal hernia and a Nigerian review on the lack of hernia registries both point to a gap. Local, real-world data on emergency hernias is scarce.
Tier 1: Strongest picks
1. Where does the delay happen in perforated appendicitis? Patient delay vs system delay
- Question: Is perforation driven more by pre-hospital delay (symptom onset to arrival) or in-hospital delay (arrival to incision)?
- Data: Symptom duration, prior self-medication or antibiotics, referral from another facility, arrival time, imaging time, OR time, and operative finding (perforated or not).
- Analysis: Logistic regression for perforation, plus a simple timeline figure.
- Why it's strong: It separates patient delay from system delay, so the result can change local practice. Most papers only report "duration of symptoms."
2. Parkland Grading Scale (or Sugrue score) applied retrospectively to cholecystectomy
- Question: Do operative-note descriptions of the gallbladder, graded 1 to 5, predict operative time, conversion, subtotal or bailout procedures, drain use and length of stay?
- Data: Operative notes, anaesthesia charts and discharge summaries.
- Why it's strong: It uses a validated tool, not a new invention. If grades are hard to assign from the notes, report inter-rater agreement (kappa) between you and a second reader as part of the project.
3. Local validation of existing appendicitis scores for perforation (Alvarado, AIR, RIPASA, or a published perforation model)
- Question: How well does each score discriminate perforated from non-perforated disease at your hospital? Does adding CRP, neutrophil-lymphocyte ratio (NLR) or symptom duration improve it?
- Analysis: ROC curves and AUC, with DeLong comparison.
- Why it's strong: Validation across populations is publishable. The data is routine labs plus histology or operative findings.
4. What happens while patients wait? Complications before interval cholecystectomy
- Question: For patients with symptomatic gallstones or acute cholecystitis who are discharged to wait for surgery, how many return with pancreatitis, cholangitis or recurrent cholecystitis? What predicts it?
- Data: Admission and readmission records. Compare patients who had surgery on the index admission against those who waited.
- Why it's strong: It quantifies the cost of waiting lists with real numbers. It also links to the 2025 meta-analysis on predictors of recurrent cholecystitis under non-operative management.
5. Incarcerated and strangulated hernia: who needs bowel resection?
- Question: What predicts bowel resection and mortality in emergency groin or ventral hernia? Candidates are duration of symptoms, age, hernia type, ASA grade, lactate and WBC.
- Add-on: Compare mesh and non-mesh repair when no resection was needed, looking at SSI and early outcomes.
- Why it's strong: It is directly relevant to the 2025 EAST guideline, and the cases are easy to identify from theatre registers.
Tier 2: Good, slightly narrower
6. Antibiotic regimen in perforated appendicitis. Compare monotherapy (for example, a single broad-spectrum agent) with dual or triple therapy. Outcomes are post-operative abscess, SSI, length of stay and duration of IV antibiotics. A 2025 paediatric retrospective shows this is current. An adult version from your own hospital is a fair gap.
7. Laparoscopic vs open appendicectomy in perforated disease. Outcomes are intra-abdominal abscess, SSI, ileus, length of stay and conversion. Adjust for severity, since selection bias is the main trap. A 2026 laparoscopic paper gives you a reference point for discussion.
8. Wound management after perforated appendicitis. Compare primary closure, delayed primary closure and secondary healing. Outcomes are SSI rate, return visits and length of stay.
9. Post-operative urinary retention after hernia repair. Look at anaesthesia type (spinal vs general vs local), age, BPH and fluid volume. It is small, clean, and has a simple binary outcome.
10. Histopathology of routine cholecystectomy specimens. Estimate the incidence of incidental gallbladder carcinoma and dysplasia, and relate it to age, sex, wall thickness and stone type. This is very feasible if histology reports are digitised, and it is especially interesting if you live in a high-incidence region.
Tier 3: Cross-cutting ideas that stand out
11. Frailty across all three index operations. Compute a 5-item modified frailty index from the chart (diabetes, hypertension, COPD or functional status, heart failure, dependence). Test it against complications, length of stay and readmission. A 2024 meta-analysis supports this in cholecystectomy, but combining three common operations in one cohort is uncommon.
12. After-hours and weekend surgery. Do appendicectomies, emergency cholecystectomies and emergency hernia repairs done at night or on weekends have different complication rates or conversion rates? It needs only timestamps and outcomes.
13. Audit of antibiotic prophylaxis and SSI. Check whether the right drug was given within 60 minutes before incision, and relate this to SSI across the three operations. An audit with a clear standard is easy to run.
Which one to choose
| Topic | Novelty | Data ease | Fits 20 days |
|---|---|---|---|
| 1. Delay decomposition | High | High | Yes |
| 2. Parkland grade | High | Medium | Yes |
| 3. Score validation | Medium | High | Yes |
| 4. Waiting-list complications | High | Medium | Yes |
| 5. Strangulated hernia | High | Medium to high | Yes |
| 11. Frailty across procedures | High | Medium | Tight |
20-day plan
| Days | Task |
|---|---|
| 1 to 3 | Pick the topic. Write a one-page protocol covering the question, inclusion and exclusion criteria, variables and outcomes. Submit for ethics approval or a waiver of consent. |
| 3 to 5 | Build the data sheet (Excel or Google Sheets) with coded variables and a data dictionary. Pilot it on 10 charts. |
| 5 to 13 | Collect data. Aim for 120 to 200 charts, about 15 to 20 per day. |
| 13 to 16 | Clean the data, run descriptive stats and the main analysis (SPSS, R or Jamovi). |
| 16 to 19 | Write the abstract, methods, results and discussion. Follow the STROBE checklist. |
| 19 to 20 | Review with your supervisor. Prepare tables, figures and a short slide deck. |
Risks to manage
- Ethics approval is the biggest threat to your timeline. Start the application today. Retrospective chart reviews usually qualify for expedited review or a consent waiver.
- Sample size: For logistic regression, aim for about 10 outcome events per predictor. Perforated cases are your limiting number, so count them before committing to Topic 1, 3 or 6.
- Confounding by indication matters in Topics 6, 7 and 8, because sicker patients get different treatments. Adjust in a multivariable model and be honest about it in the limitations.
- Missing data: If a variable is missing in more than about 30% of charts, drop it. Report how much is missing for each variable.
- Confidentiality: Use study IDs and keep names off the data sheet.
Tell me the hospital setting (country, paediatric or adult, electronic or paper records) and your supervisor's interest. I can then draft the protocol, data collection sheet and analysis plan for whichever one you choose.
Give me proper research topics. Tertiary care centre. My supervisors are experienced General Surgeons.
Your credits are exhausted. You can purchase a top-up or subscribe to a plan to continue using Orris. If you're already subscribed, your daily credits will reset tomorrow.
This is a shared conversation. Sign in to Orris to start your own chat.