Show that you understand the current state of research on your topic.
The length of a research proposal can vary quite a bit. A bachelor’s or master’s thesis proposal can be just a few pages, while proposals for PhD dissertations or research funding are usually much longer and more detailed. Your supervisor can help you determine the best length for your work.
One trick to get started is to think of your proposal’s structure as a shorter version of your thesis or dissertation , only without the results , conclusion and discussion sections.
Download our research proposal template
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Writing a research proposal can be quite challenging, but a good starting point could be to look at some examples. We’ve included a few for you below.
Like your dissertation or thesis, the proposal will usually have a title page that includes:
The first part of your proposal is the initial pitch for your project. Make sure it succinctly explains what you want to do and why.
Your introduction should:
To guide your introduction , include information about:
As you get started, it’s important to demonstrate that you’re familiar with the most important research on your topic. A strong literature review shows your reader that your project has a solid foundation in existing knowledge or theory. It also shows that you’re not simply repeating what other people have already done or said, but rather using existing research as a jumping-off point for your own.
In this section, share exactly how your project will contribute to ongoing conversations in the field by:
Following the literature review, restate your main objectives . This brings the focus back to your own project. Next, your research design or methodology section will describe your overall approach, and the practical steps you will take to answer your research questions.
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To finish your proposal on a strong note, explore the potential implications of your research for your field. Emphasize again what you aim to contribute and why it matters.
For example, your results might have implications for:
Last but not least, your research proposal must include correct citations for every source you have used, compiled in a reference list . To create citations quickly and easily, you can use our free APA citation generator .
Some institutions or funders require a detailed timeline of the project, asking you to forecast what you will do at each stage and how long it may take. While not always required, be sure to check the requirements of your project.
Here’s an example schedule to help you get started. You can also download a template at the button below.
Download our research schedule template
Research phase | Objectives | Deadline |
---|---|---|
1. Background research and literature review | 20th January | |
2. Research design planning | and data analysis methods | 13th February |
3. Data collection and preparation | with selected participants and code interviews | 24th March |
4. Data analysis | of interview transcripts | 22nd April |
5. Writing | 17th June | |
6. Revision | final work | 28th July |
If you are applying for research funding, chances are you will have to include a detailed budget. This shows your estimates of how much each part of your project will cost.
Make sure to check what type of costs the funding body will agree to cover. For each item, include:
To determine your budget, think about:
If you want to know more about the research process , methodology , research bias , or statistics , make sure to check out some of our other articles with explanations and examples.
Methodology
Statistics
Research bias
Once you’ve decided on your research objectives , you need to explain them in your paper, at the end of your problem statement .
Keep your research objectives clear and concise, and use appropriate verbs to accurately convey the work that you will carry out for each one.
I will compare …
A research aim is a broad statement indicating the general purpose of your research project. It should appear in your introduction at the end of your problem statement , before your research objectives.
Research objectives are more specific than your research aim. They indicate the specific ways you’ll address the overarching aim.
A PhD, which is short for philosophiae doctor (doctor of philosophy in Latin), is the highest university degree that can be obtained. In a PhD, students spend 3–5 years writing a dissertation , which aims to make a significant, original contribution to current knowledge.
A PhD is intended to prepare students for a career as a researcher, whether that be in academia, the public sector, or the private sector.
A master’s is a 1- or 2-year graduate degree that can prepare you for a variety of careers.
All master’s involve graduate-level coursework. Some are research-intensive and intend to prepare students for further study in a PhD; these usually require their students to write a master’s thesis . Others focus on professional training for a specific career.
Critical thinking refers to the ability to evaluate information and to be aware of biases or assumptions, including your own.
Like information literacy , it involves evaluating arguments, identifying and solving problems in an objective and systematic way, and clearly communicating your ideas.
The best way to remember the difference between a research plan and a research proposal is that they have fundamentally different audiences. A research plan helps you, the researcher, organize your thoughts. On the other hand, a dissertation proposal or research proposal aims to convince others (e.g., a supervisor, a funding body, or a dissertation committee) that your research topic is relevant and worthy of being conducted.
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McCombes, S. & George, T. (2023, November 21). How to Write a Research Proposal | Examples & Templates. Scribbr. Retrieved September 8, 2024, from https://www.scribbr.com/research-process/research-proposal/
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Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
Writing the proposal of a research work in the present era is a challenging task due to the constantly evolving trends in the qualitative research design and the need to incorporate medical advances into the methodology. The proposal is a detailed plan or ‘blueprint’ for the intended study, and once it is completed, the research project should flow smoothly. Even today, many of the proposals at post-graduate evaluation committees and application proposals for funding are substandard. A search was conducted with keywords such as research proposal, writing proposal and qualitative using search engines, namely, PubMed and Google Scholar, and an attempt has been made to provide broad guidelines for writing a scientifically appropriate research proposal.
A clean, well-thought-out proposal forms the backbone for the research itself and hence becomes the most important step in the process of conduct of research.[ 1 ] The objective of preparing a research proposal would be to obtain approvals from various committees including ethics committee [details under ‘Research methodology II’ section [ Table 1 ] in this issue of IJA) and to request for grants. However, there are very few universally accepted guidelines for preparation of a good quality research proposal. A search was performed with keywords such as research proposal, funding, qualitative and writing proposals using search engines, namely, PubMed, Google Scholar and Scopus.
Five ‘C’s while writing a literature review
A proposal needs to show how your work fits into what is already known about the topic and what new paradigm will it add to the literature, while specifying the question that the research will answer, establishing its significance, and the implications of the answer.[ 2 ] The proposal must be capable of convincing the evaluation committee about the credibility, achievability, practicality and reproducibility (repeatability) of the research design.[ 3 ] Four categories of audience with different expectations may be present in the evaluation committees, namely academic colleagues, policy-makers, practitioners and lay audiences who evaluate the research proposal. Tips for preparation of a good research proposal include; ‘be practical, be persuasive, make broader links, aim for crystal clarity and plan before you write’. A researcher must be balanced, with a realistic understanding of what can be achieved. Being persuasive implies that researcher must be able to convince other researchers, research funding agencies, educational institutions and supervisors that the research is worth getting approval. The aim of the researcher should be clearly stated in simple language that describes the research in a way that non-specialists can comprehend, without use of jargons. The proposal must not only demonstrate that it is based on an intelligent understanding of the existing literature but also show that the writer has thought about the time needed to conduct each stage of the research.[ 4 , 5 ]
The contents or formats of a research proposal vary depending on the requirements of evaluation committee and are generally provided by the evaluation committee or the institution.
In general, a cover page should contain the (i) title of the proposal, (ii) name and affiliation of the researcher (principal investigator) and co-investigators, (iii) institutional affiliation (degree of the investigator and the name of institution where the study will be performed), details of contact such as phone numbers, E-mail id's and lines for signatures of investigators.
The main contents of the proposal may be presented under the following headings: (i) introduction, (ii) review of literature, (iii) aims and objectives, (iv) research design and methods, (v) ethical considerations, (vi) budget, (vii) appendices and (viii) citations.[ 4 ]
It is also sometimes termed as ‘need for study’ or ‘abstract’. Introduction is an initial pitch of an idea; it sets the scene and puts the research in context.[ 6 ] The introduction should be designed to create interest in the reader about the topic and proposal. It should convey to the reader, what you want to do, what necessitates the study and your passion for the topic.[ 7 ] Some questions that can be used to assess the significance of the study are: (i) Who has an interest in the domain of inquiry? (ii) What do we already know about the topic? (iii) What has not been answered adequately in previous research and practice? (iv) How will this research add to knowledge, practice and policy in this area? Some of the evaluation committees, expect the last two questions, elaborated under a separate heading of ‘background and significance’.[ 8 ] Introduction should also contain the hypothesis behind the research design. If hypothesis cannot be constructed, the line of inquiry to be used in the research must be indicated.
It refers to all sources of scientific evidence pertaining to the topic in interest. In the present era of digitalisation and easy accessibility, there is an enormous amount of relevant data available, making it a challenge for the researcher to include all of it in his/her review.[ 9 ] It is crucial to structure this section intelligently so that the reader can grasp the argument related to your study in relation to that of other researchers, while still demonstrating to your readers that your work is original and innovative. It is preferable to summarise each article in a paragraph, highlighting the details pertinent to the topic of interest. The progression of review can move from the more general to the more focused studies, or a historical progression can be used to develop the story, without making it exhaustive.[ 1 ] Literature should include supporting data, disagreements and controversies. Five ‘C's may be kept in mind while writing a literature review[ 10 ] [ Table 1 ].
The research purpose (or goal or aim) gives a broad indication of what the researcher wishes to achieve in the research. The hypothesis to be tested can be the aim of the study. The objectives related to parameters or tools used to achieve the aim are generally categorised as primary and secondary objectives.
The objective here is to convince the reader that the overall research design and methods of analysis will correctly address the research problem and to impress upon the reader that the methodology/sources chosen are appropriate for the specific topic. It should be unmistakably tied to the specific aims of your study.
In this section, the methods and sources used to conduct the research must be discussed, including specific references to sites, databases, key texts or authors that will be indispensable to the project. There should be specific mention about the methodological approaches to be undertaken to gather information, about the techniques to be used to analyse it and about the tests of external validity to which researcher is committed.[ 10 , 11 ]
The components of this section include the following:[ 4 ]
Population refers to all the elements (individuals, objects or substances) that meet certain criteria for inclusion in a given universe,[ 12 ] and sample refers to subset of population which meets the inclusion criteria for enrolment into the study. The inclusion and exclusion criteria should be clearly defined. The details pertaining to sample size are discussed in the article “Sample size calculation: Basic priniciples” published in this issue of IJA.
The researcher is expected to give a detailed account of the methodology adopted for collection of data, which include the time frame required for the research. The methodology should be tested for its validity and ensure that, in pursuit of achieving the results, the participant's life is not jeopardised. The author should anticipate and acknowledge any potential barrier and pitfall in carrying out the research design and explain plans to address them, thereby avoiding lacunae due to incomplete data collection. If the researcher is planning to acquire data through interviews or questionnaires, copy of the questions used for the same should be attached as an annexure with the proposal.
This addresses the strength of the research with respect to its neutrality, consistency and applicability. Rigor must be reflected throughout the proposal.
It refers to the robustness of a research method against bias. The author should convey the measures taken to avoid bias, viz. blinding and randomisation, in an elaborate way, thus ensuring that the result obtained from the adopted method is purely as chance and not influenced by other confounding variables.
Consistency considers whether the findings will be consistent if the inquiry was replicated with the same participants and in a similar context. This can be achieved by adopting standard and universally accepted methods and scales.
Applicability refers to the degree to which the findings can be applied to different contexts and groups.[ 13 ]
This section deals with the reduction and reconstruction of data and its analysis including sample size calculation. The researcher is expected to explain the steps adopted for coding and sorting the data obtained. Various tests to be used to analyse the data for its robustness, significance should be clearly stated. Author should also mention the names of statistician and suitable software which will be used in due course of data analysis and their contribution to data analysis and sample calculation.[ 9 ]
Medical research introduces special moral and ethical problems that are not usually encountered by other researchers during data collection, and hence, the researcher should take special care in ensuring that ethical standards are met. Ethical considerations refer to the protection of the participants' rights (right to self-determination, right to privacy, right to autonomy and confidentiality, right to fair treatment and right to protection from discomfort and harm), obtaining informed consent and the institutional review process (ethical approval). The researcher needs to provide adequate information on each of these aspects.
Informed consent needs to be obtained from the participants (details discussed in further chapters), as well as the research site and the relevant authorities.
When the researcher prepares a research budget, he/she should predict and cost all aspects of the research and then add an additional allowance for unpredictable disasters, delays and rising costs. All items in the budget should be justified.
Appendices are documents that support the proposal and application. The appendices will be specific for each proposal but documents that are usually required include informed consent form, supporting documents, questionnaires, measurement tools and patient information of the study in layman's language.
As with any scholarly research paper, you must cite the sources you used in composing your proposal. Although the words ‘references and bibliography’ are different, they are used interchangeably. It refers to all references cited in the research proposal.
Successful, qualitative research proposals should communicate the researcher's knowledge of the field and method and convey the emergent nature of the qualitative design. The proposal should follow a discernible logic from the introduction to presentation of the appendices.
Conflicts of interest.
There are no conflicts of interest.
A research proposal is a concise and coherent summary of your proposed research.
Your research proposal should set out the central issues or questions that you intend to address. It should outline the general area of study within which your research falls, referring to the current state of knowledge and any recent debates on the topic, as well as demonstrate the originality of your proposed research.
The proposal also gives you an opportunity to show that you have the aptitude for postgraduate level research by demonstrating that you have the ability to communicate complex ideas clearly, concisely and critically.
In addition, the proposal also helps us to match your research interest with an appropriate supervisor. The proposal is a key part of your application, on which potential supervisors will decide if your research is something they can support.
Read our advice on research proposal preparation
Additional guidance for applicants from the USA
Parts of a research proposal, prosana model, introduction, research question, methodology.
A research proposal's purpose is to capture the evaluator's attention, demonstrate the study's potential benefits, and prove that it is a logical and consistent approach (Van Ekelenburg, 2010). To ensure that your research proposal contains these elements, there are several aspects to include in your proposal (Al-Riyami, 2008):
Details about what to include in each element are included in the boxes below. Depending on the topic of your study, some parts may not apply to your proposal. You can also watch the video below for a brief overview about writing a successful research proposal.
Van Ekelenburg (2010) uses the PROSANA Model to guide researchers in developing rationale and justification for their research projects. It is an acronym that connects the problem, solution, and benefits of a particular research project. It is an easy way to remember the critical parts of a research proposal and how they relate to one another. It includes the following letters (Van Ekelenburg, 2010):
Research proposal titles should be concise and to the point, but informative. The title of your proposal may be different from the title of your final research project, but that is completely normal! Your findings may help you come up with a title that is more fitting for the final project. Characteristics of good proposal titles are (Al-Riyami, 2008):
It is also common for proposal titles to be very similar to your research question, hypothesis, or thesis statement (Locke et al., 2007).
An abstract is a brief summary (about 300 words) of the study you are proposing. It includes the following elements (Al-Riyami, 2008):
Our guide on writing summaries may help you with this step.
The purpose of the introduction is to give readers background information about your topic. it gives the readers a basic understanding of your topic so that they can further understand the significance of your proposal. A good introduction will explain (Al-Riyami, 2008):
Your research objectives are the desired outcomes that you will achieve from the research project. Depending on your research design, these may be generic or very specific. You may also have more than one objective (Al-Riyami, 2008).
Be careful not to have too many objectives in your proposal, as having too many can make your project lose focus. Plus, it may not be possible to achieve several objectives in one study.
This section describes the different types of variables that you plan to have in your study and how you will measure them. According to Al-Riyami (2008), there are four types of research variables:
Your research proposal should describe each of your variables and how they relate to one another. Depending on your study, you may not have all four types of variables present. However, there will always be an independent and dependent variable.
A research question is the main piece of your research project because it explains what your study will discover to the reader. It is the question that fuels the study, so it is important for it to be precise and unique. You do not want it to be too broad, and it should identify a relationship between two variables (an independent and a dependent) (Al-Riyami, 2008). There are six types of research questions (Academic Writer, n.d.):
For more information on the different types of research questions, you can view the "Research Questions and Hypotheses" tutorial on Academic Writer, located below. If you are unfamiliar with Academic Writer, we also have a tutorial on using the database located below.
Compose papers in pre-formatted APA templates. Manage references in forms that help craft APA citations. Learn the rules of APA style through tutorials and practice quizzes.
Academic Writer will continue to use the 6th edition guidelines until August 2020. A preview of the 7th edition is available in the footer of the resource's site. Previously known as APA Style Central.
If you know enough about your research topic that you believe a particular outcome may occur as a result of the study, you can include a hypothesis (thesis statement) in your proposal. A hypothesis is a prediction that you believe will be the outcome of your study. It explains what you think the relationship will be between the independent and dependent variable (Al-Riyami, 2008). It is ok if the hypothesis in your proposal turns out to be incorrect, because it is only a prediction! If you are writing a proposal in the humanities, you may be writing a thesis statement instead of a hypothesis. A thesis presents the main argument of your research project and leads to corresponding evidence to support your argument.
Hypotheses vs. Theories
Hypotheses are different from theories in that theories represent general principles and sets of rules that explain different phenomena. They typically represent large areas of study because they are applicable to anything in a particular field. Hypotheses focus on specific areas within a field and are educated guesses, meaning that they have the potential to be proven wrong (Academic Writer, n.d.). Because of this, hypotheses can also be formed from theories.
For more information on writing effective thesis statements, you can view our guide on writing thesis statements below.
In a research proposal, you must thoroughly explain how you will conduct your study. This includes things such as (Al-Riyami, 2008):
For more information on research methodologies, you can view our guide on research methods and methodologies below.
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Learning objectives.
Writing a good research paper takes time, thought, and effort. Although this assignment is challenging, it is manageable. Focusing on one step at a time will help you develop a thoughtful, informative, well-supported research paper.
Your first step is to choose a topic and then to develop research questions, a working thesis, and a written research proposal. Set aside adequate time for this part of the process. Fully exploring ideas will help you build a solid foundation for your paper.
When you choose a topic for a research paper, you are making a major commitment. Your choice will help determine whether you enjoy the lengthy process of research and writing—and whether your final paper fulfills the assignment requirements. If you choose your topic hastily, you may later find it difficult to work with your topic. By taking your time and choosing carefully, you can ensure that this assignment is not only challenging but also rewarding.
Writers understand the importance of choosing a topic that fulfills the assignment requirements and fits the assignment’s purpose and audience. (For more information about purpose and audience, see Chapter 6 “Writing Paragraphs: Separating Ideas and Shaping Content” .) Choosing a topic that interests you is also crucial. You instructor may provide a list of suggested topics or ask that you develop a topic on your own. In either case, try to identify topics that genuinely interest you.
After identifying potential topic ideas, you will need to evaluate your ideas and choose one topic to pursue. Will you be able to find enough information about the topic? Can you develop a paper about this topic that presents and supports your original ideas? Is the topic too broad or too narrow for the scope of the assignment? If so, can you modify it so it is more manageable? You will ask these questions during this preliminary phase of the research process.
Sometimes, your instructor may provide a list of suggested topics. If so, you may benefit from identifying several possibilities before committing to one idea. It is important to know how to narrow down your ideas into a concise, manageable thesis. You may also use the list as a starting point to help you identify additional, related topics. Discussing your ideas with your instructor will help ensure that you choose a manageable topic that fits the requirements of the assignment.
In this chapter, you will follow a writer named Jorge, who is studying health care administration, as he prepares a research paper. You will also plan, research, and draft your own research paper.
Jorge was assigned to write a research paper on health and the media for an introductory course in health care. Although a general topic was selected for the students, Jorge had to decide which specific issues interested him. He brainstormed a list of possibilities.
If you are writing a research paper for a specialized course, look back through your notes and course activities. Identify reading assignments and class discussions that especially engaged you. Doing so can help you identify topics to pursue.
Set a timer for five minutes. Use brainstorming or idea mapping to create a list of topics you would be interested in researching for a paper about the influence of the Internet on social networking. Do you closely follow the media coverage of a particular website, such as Twitter? Would you like to learn more about a certain industry, such as online dating? Which social networking sites do you and your friends use? List as many ideas related to this topic as you can.
Once you have a list of potential topics, you will need to choose one as the focus of your essay. You will also need to narrow your topic. Most writers find that the topics they listed during brainstorming or idea mapping are broad—too broad for the scope of the assignment. Working with an overly broad topic, such as sexual education programs or popularized diets, can be frustrating and overwhelming. Each topic has so many facets that it would be impossible to cover them all in a college research paper. However, more specific choices, such as the pros and cons of sexual education in kids’ television programs or the physical effects of the South Beach diet, are specific enough to write about without being too narrow to sustain an entire research paper.
A good research paper provides focused, in-depth information and analysis. If your topic is too broad, you will find it difficult to do more than skim the surface when you research it and write about it. Narrowing your focus is essential to making your topic manageable. To narrow your focus, explore your topic in writing, conduct preliminary research, and discuss both the topic and the research with others.
“How am I supposed to narrow my topic when I haven’t even begun researching yet?” In fact, you may already know more than you realize. Review your list and identify your top two or three topics. Set aside some time to explore each one through freewriting. (For more information about freewriting, see Chapter 8 “The Writing Process: How Do I Begin?” .) Simply taking the time to focus on your topic may yield fresh angles.
Jorge knew that he was especially interested in the topic of diet fads, but he also knew that it was much too broad for his assignment. He used freewriting to explore his thoughts so he could narrow his topic. Read Jorge’s ideas.
Another way writers may focus a topic is to conduct preliminary research . Like freewriting, exploratory reading can help you identify interesting angles. Surfing the web and browsing through newspaper and magazine articles are good ways to start. Find out what people are saying about your topic on blogs and online discussion groups. Discussing your topic with others can also inspire you. Talk about your ideas with your classmates, your friends, or your instructor.
Jorge’s freewriting exercise helped him realize that the assigned topic of health and the media intersected with a few of his interests—diet, nutrition, and obesity. Preliminary online research and discussions with his classmates strengthened his impression that many people are confused or misled by media coverage of these subjects.
Jorge decided to focus his paper on a topic that had garnered a great deal of media attention—low-carbohydrate diets. He wanted to find out whether low-carbohydrate diets were as effective as their proponents claimed.
At work, you may need to research a topic quickly to find general information. This information can be useful in understanding trends in a given industry or generating competition. For example, a company may research a competitor’s prices and use the information when pricing their own product. You may find it useful to skim a variety of reliable sources and take notes on your findings.
The reliability of online sources varies greatly. In this exploratory phase of your research, you do not need to evaluate sources as closely as you will later. However, use common sense as you refine your paper topic. If you read a fascinating blog comment that gives you a new idea for your paper, be sure to check out other, more reliable sources as well to make sure the idea is worth pursuing.
Review the list of topics you created in Note 11.18 “Exercise 1” and identify two or three topics you would like to explore further. For each of these topics, spend five to ten minutes writing about the topic without stopping. Then review your writing to identify possible areas of focus.
Set aside time to conduct preliminary research about your potential topics. Then choose a topic to pursue for your research paper.
Collaboration
Please share your topic list with a classmate. Select one or two topics on his or her list that you would like to learn more about and return it to him or her. Discuss why you found the topics interesting, and learn which of your topics your classmate selected and why.
Your freewriting and preliminary research have helped you choose a focused, manageable topic for your research paper. To work with your topic successfully, you will need to determine what exactly you want to learn about it—and later, what you want to say about it. Before you begin conducting in-depth research, you will further define your focus by developing a research question , a working thesis, and a research proposal.
In forming a research question, you are setting a goal for your research. Your main research question should be substantial enough to form the guiding principle of your paper—but focused enough to guide your research. A strong research question requires you not only to find information but also to put together different pieces of information, interpret and analyze them, and figure out what you think. As you consider potential research questions, ask yourself whether they would be too hard or too easy to answer.
To determine your research question, review the freewriting you completed earlier. Skim through books, articles, and websites and list the questions you have. (You may wish to use the 5WH strategy to help you formulate questions. See Chapter 8 “The Writing Process: How Do I Begin?” for more information about 5WH questions.) Include simple, factual questions and more complex questions that would require analysis and interpretation. Determine your main question—the primary focus of your paper—and several subquestions that you will need to research to answer your main question.
Here are the research questions Jorge will use to focus his research. Notice that his main research question has no obvious, straightforward answer. Jorge will need to research his subquestions, which address narrower topics, to answer his main question.
Using the topic you selected in Note 11.24 “Exercise 2” , write your main research question and at least four to five subquestions. Check that your main research question is appropriately complex for your assignment.
A working thesis concisely states a writer’s initial answer to the main research question. It does not merely state a fact or present a subjective opinion. Instead, it expresses a debatable idea or claim that you hope to prove through additional research. Your working thesis is called a working thesis for a reason—it is subject to change. As you learn more about your topic, you may change your thinking in light of your research findings. Let your working thesis serve as a guide to your research, but do not be afraid to modify it based on what you learn.
Jorge began his research with a strong point of view based on his preliminary writing and research. Read his working thesis statement, which presents the point he will argue. Notice how it states Jorge’s tentative answer to his research question.
One way to determine your working thesis is to consider how you would complete sentences such as I believe or My opinion is . However, keep in mind that academic writing generally does not use first-person pronouns. These statements are useful starting points, but formal research papers use an objective voice.
Write a working thesis statement that presents your preliminary answer to the research question you wrote in Note 11.27 “Exercise 3” . Check that your working thesis statement presents an idea or claim that could be supported or refuted by evidence from research.
A research proposal is a brief document—no more than one typed page—that summarizes the preliminary work you have completed. Your purpose in writing it is to formalize your plan for research and present it to your instructor for feedback. In your research proposal, you will present your main research question, related subquestions, and working thesis. You will also briefly discuss the value of researching this topic and indicate how you plan to gather information.
When Jorge began drafting his research proposal, he realized that he had already created most of the pieces he needed. However, he knew he also had to explain how his research would be relevant to other future health care professionals. In addition, he wanted to form a general plan for doing the research and identifying potentially useful sources. Read Jorge’s research proposal.
Before you begin a new project at work, you may have to develop a project summary document that states the purpose of the project, explains why it would be a wise use of company resources, and briefly outlines the steps involved in completing the project. This type of document is similar to a research proposal. Both documents define and limit a project, explain its value, discuss how to proceed, and identify what resources you will use.
Now you may write your own research proposal, if you have not done so already. Follow the guidelines provided in this lesson.
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Dr. Chris Drew is the founder of the Helpful Professor. He holds a PhD in education and has published over 20 articles in scholarly journals. He is the former editor of the Journal of Learning Development in Higher Education. [Image Descriptor: Photo of Chris]
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A research proposal systematically and transparently outlines a proposed research project.
The purpose of a research proposal is to demonstrate a project’s viability and the researcher’s preparedness to conduct an academic study. It serves as a roadmap for the researcher.
The process holds value both externally (for accountability purposes and often as a requirement for a grant application) and intrinsic value (for helping the researcher to clarify the mechanics, purpose, and potential signficance of the study).
Key sections of a research proposal include: the title, abstract, introduction, literature review, research design and methods, timeline, budget, outcomes and implications, references, and appendix. Each is briefly explained below.
Watch my Guide: How to Write a Research Proposal
Get your Template for Writing your Research Proposal Here (With AI Prompts!)
Title: The title should present a concise and descriptive statement that clearly conveys the core idea of the research projects. Make it as specific as possible. The reader should immediately be able to grasp the core idea of the intended research project. Often, the title is left too vague and does not help give an understanding of what exactly the study looks at.
Abstract: Abstracts are usually around 250-300 words and provide an overview of what is to follow – including the research problem , objectives, methods, expected outcomes, and significance of the study. Use it as a roadmap and ensure that, if the abstract is the only thing someone reads, they’ll get a good fly-by of what will be discussed in the peice.
Introduction: Introductions are all about contextualization. They often set the background information with a statement of the problem. At the end of the introduction, the reader should understand what the rationale for the study truly is. I like to see the research questions or hypotheses included in the introduction and I like to get a good understanding of what the significance of the research will be. It’s often easiest to write the introduction last
Literature Review: The literature review dives deep into the existing literature on the topic, demosntrating your thorough understanding of the existing literature including themes, strengths, weaknesses, and gaps in the literature. It serves both to demonstrate your knowledge of the field and, to demonstrate how the proposed study will fit alongside the literature on the topic. A good literature review concludes by clearly demonstrating how your research will contribute something new and innovative to the conversation in the literature.
Research Design and Methods: This section needs to clearly demonstrate how the data will be gathered and analyzed in a systematic and academically sound manner. Here, you need to demonstrate that the conclusions of your research will be both valid and reliable. Common points discussed in the research design and methods section include highlighting the research paradigm, methodologies, intended population or sample to be studied, data collection techniques, and data analysis procedures . Toward the end of this section, you are encouraged to also address ethical considerations and limitations of the research process , but also to explain why you chose your research design and how you are mitigating the identified risks and limitations.
Timeline: Provide an outline of the anticipated timeline for the study. Break it down into its various stages (including data collection, data analysis, and report writing). The goal of this section is firstly to establish a reasonable breakdown of steps for you to follow and secondly to demonstrate to the assessors that your project is practicable and feasible.
Budget: Estimate the costs associated with the research project and include evidence for your estimations. Typical costs include staffing costs, equipment, travel, and data collection tools. When applying for a scholarship, the budget should demonstrate that you are being responsible with your expensive and that your funding application is reasonable.
Expected Outcomes and Implications: A discussion of the anticipated findings or results of the research, as well as the potential contributions to the existing knowledge, theory, or practice in the field. This section should also address the potential impact of the research on relevant stakeholders and any broader implications for policy or practice.
References: A complete list of all the sources cited in the research proposal, formatted according to the required citation style. This demonstrates the researcher’s familiarity with the relevant literature and ensures proper attribution of ideas and information.
Appendices (if applicable): Any additional materials, such as questionnaires, interview guides, or consent forms, that provide further information or support for the research proposal. These materials should be included as appendices at the end of the document.
Research proposals often extend anywhere between 2,000 and 15,000 words in length. The following snippets are samples designed to briefly demonstrate what might be discussed in each section.
See some real sample pieces:
Consider this hypothetical education research proposal:
The Impact of Game-Based Learning on Student Engagement and Academic Performance in Middle School Mathematics
Abstract: The proposed study will explore multiplayer game-based learning techniques in middle school mathematics curricula and their effects on student engagement. The study aims to contribute to the current literature on game-based learning by examining the effects of multiplayer gaming in learning.
Introduction: Digital game-based learning has long been shunned within mathematics education for fears that it may distract students or lower the academic integrity of the classrooms. However, there is emerging evidence that digital games in math have emerging benefits not only for engagement but also academic skill development. Contributing to this discourse, this study seeks to explore the potential benefits of multiplayer digital game-based learning by examining its impact on middle school students’ engagement and academic performance in a mathematics class.
Literature Review: The literature review has identified gaps in the current knowledge, namely, while game-based learning has been extensively explored, the role of multiplayer games in supporting learning has not been studied.
Research Design and Methods: This study will employ a mixed-methods research design based upon action research in the classroom. A quasi-experimental pre-test/post-test control group design will first be used to compare the academic performance and engagement of middle school students exposed to game-based learning techniques with those in a control group receiving instruction without the aid of technology. Students will also be observed and interviewed in regard to the effect of communication and collaboration during gameplay on their learning.
Timeline: The study will take place across the second term of the school year with a pre-test taking place on the first day of the term and the post-test taking place on Wednesday in Week 10.
Budget: The key budgetary requirements will be the technologies required, including the subscription cost for the identified games and computers.
Expected Outcomes and Implications: It is expected that the findings will contribute to the current literature on game-based learning and inform educational practices, providing educators and policymakers with insights into how to better support student achievement in mathematics.
See some real examples:
Consider this hypothetical psychology research proposal:
The Effects of Mindfulness-Based Interventions on Stress Reduction in College Students
Abstract: This research proposal examines the impact of mindfulness-based interventions on stress reduction among college students, using a pre-test/post-test experimental design with both quantitative and qualitative data collection methods .
Introduction: College students face heightened stress levels during exam weeks. This can affect both mental health and test performance. This study explores the potential benefits of mindfulness-based interventions such as meditation as a way to mediate stress levels in the weeks leading up to exam time.
Literature Review: Existing research on mindfulness-based meditation has shown the ability for mindfulness to increase metacognition, decrease anxiety levels, and decrease stress. Existing literature has looked at workplace, high school and general college-level applications. This study will contribute to the corpus of literature by exploring the effects of mindfulness directly in the context of exam weeks.
Research Design and Methods: Participants ( n= 234 ) will be randomly assigned to either an experimental group, receiving 5 days per week of 10-minute mindfulness-based interventions, or a control group, receiving no intervention. Data will be collected through self-report questionnaires, measuring stress levels, semi-structured interviews exploring participants’ experiences, and students’ test scores.
Timeline: The study will begin three weeks before the students’ exam week and conclude after each student’s final exam. Data collection will occur at the beginning (pre-test of self-reported stress levels) and end (post-test) of the three weeks.
Expected Outcomes and Implications: The study aims to provide evidence supporting the effectiveness of mindfulness-based interventions in reducing stress among college students in the lead up to exams, with potential implications for mental health support and stress management programs on college campuses.
Consider this hypothetical sociology research proposal:
The Impact of Social Media Usage on Interpersonal Relationships among Young Adults
Abstract: This research proposal investigates the effects of social media usage on interpersonal relationships among young adults, using a longitudinal mixed-methods approach with ongoing semi-structured interviews to collect qualitative data.
Introduction: Social media platforms have become a key medium for the development of interpersonal relationships, particularly for young adults. This study examines the potential positive and negative effects of social media usage on young adults’ relationships and development over time.
Literature Review: A preliminary review of relevant literature has demonstrated that social media usage is central to development of a personal identity and relationships with others with similar subcultural interests. However, it has also been accompanied by data on mental health deline and deteriorating off-screen relationships. The literature is to-date lacking important longitudinal data on these topics.
Research Design and Methods: Participants ( n = 454 ) will be young adults aged 18-24. Ongoing self-report surveys will assess participants’ social media usage, relationship satisfaction, and communication patterns. A subset of participants will be selected for longitudinal in-depth interviews starting at age 18 and continuing for 5 years.
Timeline: The study will be conducted over a period of five years, including recruitment, data collection, analysis, and report writing.
Expected Outcomes and Implications: This study aims to provide insights into the complex relationship between social media usage and interpersonal relationships among young adults, potentially informing social policies and mental health support related to social media use.
Consider this hypothetical nursing research proposal:
The Influence of Nurse-Patient Communication on Patient Satisfaction and Health Outcomes following Emergency Cesarians
Abstract: This research will examines the impact of effective nurse-patient communication on patient satisfaction and health outcomes for women following c-sections, utilizing a mixed-methods approach with patient surveys and semi-structured interviews.
Introduction: It has long been known that effective communication between nurses and patients is crucial for quality care. However, additional complications arise following emergency c-sections due to the interaction between new mother’s changing roles and recovery from surgery.
Literature Review: A review of the literature demonstrates the importance of nurse-patient communication, its impact on patient satisfaction, and potential links to health outcomes. However, communication between nurses and new mothers is less examined, and the specific experiences of those who have given birth via emergency c-section are to date unexamined.
Research Design and Methods: Participants will be patients in a hospital setting who have recently had an emergency c-section. A self-report survey will assess their satisfaction with nurse-patient communication and perceived health outcomes. A subset of participants will be selected for in-depth interviews to explore their experiences and perceptions of the communication with their nurses.
Timeline: The study will be conducted over a period of six months, including rolling recruitment, data collection, analysis, and report writing within the hospital.
Expected Outcomes and Implications: This study aims to provide evidence for the significance of nurse-patient communication in supporting new mothers who have had an emergency c-section. Recommendations will be presented for supporting nurses and midwives in improving outcomes for new mothers who had complications during birth.
Consider this hypothetical social work research proposal:
The Role of a Family-Centered Intervention in Preventing Homelessness Among At-Risk Youthin a working-class town in Northern England
Abstract: This research proposal investigates the effectiveness of a family-centered intervention provided by a local council area in preventing homelessness among at-risk youth. This case study will use a mixed-methods approach with program evaluation data and semi-structured interviews to collect quantitative and qualitative data .
Introduction: Homelessness among youth remains a significant social issue. This study aims to assess the effectiveness of family-centered interventions in addressing this problem and identify factors that contribute to successful prevention strategies.
Literature Review: A review of the literature has demonstrated several key factors contributing to youth homelessness including lack of parental support, lack of social support, and low levels of family involvement. It also demonstrates the important role of family-centered interventions in addressing this issue. Drawing on current evidence, this study explores the effectiveness of one such intervention in preventing homelessness among at-risk youth in a working-class town in Northern England.
Research Design and Methods: The study will evaluate a new family-centered intervention program targeting at-risk youth and their families. Quantitative data on program outcomes, including housing stability and family functioning, will be collected through program records and evaluation reports. Semi-structured interviews with program staff, participants, and relevant stakeholders will provide qualitative insights into the factors contributing to program success or failure.
Timeline: The study will be conducted over a period of six months, including recruitment, data collection, analysis, and report writing.
Budget: Expenses include access to program evaluation data, interview materials, data analysis software, and any related travel costs for in-person interviews.
Expected Outcomes and Implications: This study aims to provide evidence for the effectiveness of family-centered interventions in preventing youth homelessness, potentially informing the expansion of or necessary changes to social work practices in Northern England.
Get your Detailed Template for Writing your Research Proposal Here (With AI Prompts!)
This is a template for a 2500-word research proposal. You may find it difficult to squeeze everything into this wordcount, but it’s a common wordcount for Honors and MA-level dissertations.
Section | Checklist |
---|---|
Title | – Ensure the single-sentence title clearly states the study’s focus |
Abstract (Words: 200) | – Briefly describe the research topicSummarize the research problem or question – Outline the research design and methods – Mention the expected outcomes and implications |
Introduction (Words: 300) | – Introduce the research topic and its significance – Clearly state the research problem or question – Explain the purpose and objectives of the study – Provide a brief overview of |
Literature Review (Words: 800) | – Gather the existing literature into themes and ket ideas – the themes and key ideas in the literature – Identify gaps or inconsistencies in the literature – Explain how the current study will contribute to the literature |
Research Design and Methods (Words; 800) | – Describe the research paradigm (generally: positivism and interpretivism) – Describe the research design (e.g., qualitative, quantitative, or mixed-methods) – Explain the data collection methods (e.g., surveys, interviews, observations) – Detail the sampling strategy and target population – Outline the data analysis techniques (e.g., statistical analysis, thematic analysis) – Outline your validity and reliability procedures – Outline your intended ethics procedures – Explain the study design’s limitations and justify your decisions |
Timeline (Single page table) | – Provide an overview of the research timeline – Break down the study into stages with specific timeframes (e.g., data collection, analysis, report writing) – Include any relevant deadlines or milestones |
Budget (200 words) | – Estimate the costs associated with the research project – Detail specific expenses (e.g., materials, participant incentives, travel costs) – Include any necessary justifications for the budget items – Mention any funding sources or grant applications |
Expected Outcomes and Implications (200 words) | – Summarize the anticipated findings or results of the study – Discuss the potential implications of the findings for theory, practice, or policy – Describe any possible limitations of the study |
Your research proposal is where you really get going with your study. I’d strongly recommend working closely with your teacher in developing a research proposal that’s consistent with the requirements and culture of your institution, as in my experience it varies considerably. The above template is from my own courses that walk students through research proposals in a British School of Education.
Very excellent research proposals
very helpful
Very helpful
Dear Sir, I need some help to write an educational research proposal. Thank you.
Hi Levi, use the site search bar to ask a question and I’ll likely have a guide already written for your specific question. Thanks for reading!
very good research proposal
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In her campaign for president, Vice President Kamala Harris has embraced all the tax A tax is a mandatory payment or charge collected by local, state, and national governments from individuals or businesses to cover the costs of general government services, goods, and activities. increases President Biden proposed in the White House fiscal year 2025 budget —including a new idea that would require taxpayers with net wealth above $100 million to pay a minimum tax on their unrealized capital gains from assets such as stocks, bonds, or privately held companies.
The so-called billionaire minimum tax would take the tax code in the wrong direction by imposing a complicated tax on a narrow segment of high-earning taxpayers in a way that’s never been tried. This proposal would add new compliance burdens for taxpayers and administrative challenges for the IRS while weakening the US economy by raising the tax burden on saving and entrepreneurship. It would also require a new wealth reporting system, allowing the IRS to track the wealth of an unspecified number of Americans every year (some people with less than $100 million of wealth would be required to report it to the IRS).
Under current law, taxpayers pay taxes on the growth in the value of their assets when they are sold (or realized). Gains on assets held for less than one year are subject to ordinary income tax rates, while gains on assets held for longer than one year are taxed at a top rate of 23.8 percent. Additionally, inherited assets receive a “step-up” in tax basis, eliminating tax owed on capital gains.
Under the new proposal, taxpayers with net wealth above $100 million would be required to pay a minimum effective tax rate of 25 percent on an expanded measure of income that includes their unrealized capital gains. Taxpayers would calculate their effective tax rate for the minimum tax and, if it fell below 25 percent, would owe additional taxes to bring their effective rate to 25 percent. Any additional taxes owed because of the minimum tax would be payable over nine years initially, and over five years going forward.
The change means wealthy taxpayers would owe taxes on capital gains each year, even if the underlying asset had not been sold. Any amounts paid would be treated as prepayments of future capital gains tax liability. For example, consider a taxpayer with net wealth of $200 million, $5 million in ordinary income, $10 million in accumulated unrealized capital gains from a privately held company, and an ordinary tax liability of $1.8 million (see accompanying table). When including unrealized capital gains as income, the household’s effective tax rate is 12 percent, below the proposed 25 percent minimum.
To increase their effective tax rate to 25 percent, the household would owe an additional $1.95 million in tax (resulting in a combined $3.75 million in taxes owed on $15 million of income when including unrealized gains). The $1.95 million could be paid in equal installments over nine years (for capital gains moving forward, minimum tax liability can be split into five annual installments) and would be credited against future capital gains tax A capital gains tax is levied on the profit made from selling an asset and is often in addition to corporate income taxes, frequently resulting in double taxation. These taxes create a bias against saving, leading to a lower level of national income by encouraging present consumption over investment. liability on the asset when sold.
Step of the Calculation | Amount | Notes |
---|---|---|
A. Net Wealth | $200 million | Tax phases in starting at $100 million in net wealth and applies fully to taxpayers with net wealth over $200 million (unclear if the proposal will index thresholds to inflation) |
B. Ordinary Income | $5 million | |
C. Ordinary Income Tax Owed | $1.8 million (B * ordinary effective tax rate of 35.5%) | Ordinary income tax liability without additional deductions from ordinary income or credits offsetting tax owed |
D. Unrealized Capital Gains | $10 million | Unrealized gains from increase in value of privately held company |
E. Original Minimum Tax Effective Tax Rate | 12% (C / B+D) | Effective tax rate inclusive of unrealized gains before the minimum tax payment |
F. Minimum Tax Owed | $1.95 million | Total prepaid tax owed to raise effective tax rate inclusive of unrealized gains to 25% |
G. New Effective Tax Rate under Minimum Tax | 25% (C + F / B+D) | Effective tax rate inclusive of unrealized gains including the minimum tax payment |
When the taxpayer eventually sells the company, the taxpayer would square up their taxes by using the prepaid taxes to offset capital gains tax liability. For example, if the household sold the private company in the future and owed $2 million in capital gains taxes, the taxpayer would reduce their liability by the $1.95 million prepayment and only owe an additional $50,000.
If the asset declined in value in a future year before being sold, it would produce an unrealized capital loss, reducing the taxpayer’s tax liability. An unrealized loss would first reduce remaining installments of tax owed on previous unrealized gains before being refunded in cash.
Overall, the proposal moves in the opposite direction of sound tax policy.
Changing the definition of taxable income to include unrealized capital gains presents significant administrative challenges, including how to value non-tradable assets and how to treat illiquid taxpayers who may have paper gains but lack cash on hand to pay their minimum tax bill.
The proposal attempts to meet such challenges with an entirely separate tax regime involving a deferral charge instead of prepayments for non-tradable assets and by allowing payment periods of nine years and five years. All options, however, introduce new complexities, opportunities for tax planning, and the potential of disputes with the IRS—in other words, economically wasteful activities. Additionally, the tax is levied on assets net of debts, meaning it could encourage additional borrowing to avoid the tax , unless mitigating rules are added.
The proposal would increase the tax burden on US savers, placing foreign savers at a relative advantage as they would not face the minimum tax. Raising taxes on domestic savers reduces the amount of domestic saving in the economy. In turn, foreign savers would finance a greater share of investment opportunities in the US. Over the long run, American incomes would fall as investment returns flowed to foreign savers instead of American savers. It would also manifest in a shifted balance of trade, increasing the trade deficit, all else held equal.
A higher effective tax rate on capital gains could also discourage angel investing , entrepreneurship, and risk-taking , reducing financing options for start-ups and leading to less economic dynamism.
The proposal runs contrary to international norms, as most countries in the Organisation for Economic Co-operation and Development tax capital gains when they are realized, and at lower rates than the US, and tax capital income overall at lower average tax rates .
Another challenge is the minimum tax would likely be an unstable source of revenue. Much of the estimated revenue it would raise in the first decade is from taxing previously accumulated capital gains. Once taxes on the past accumulation of capital gains are paid, the permanent increase in revenue going forward would be smaller. Furthermore, because the revenue would depend on how taxpayers’ assets perform on paper , volatility in the stock market and the broader economy would translate into volatile revenue collections.
Harris’s billionaire minimum tax proposal would be a highly complicated new tax regime, creating new compliance costs for taxpayers and difficult administrative challenges for an already overwhelmed IRS without serving as a stable source of permanent funding. In addition, the economic harm could be substantial, as it would reduce saving, entrepreneurship, and economic dynamism. If lawmakers are seeking to raise revenue from top earners, they have much better options , such as progressive consumption taxes.
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Objectives To develop a consensual definition for the term ‘early axial spondyloarthritis—axSpA’—and ‘early peripheral spondyloarthritis—pSpA’.
Methods The ASAS (Assessment of SpondyloArthritis international Society-Spondyloarthritis EARly definition) steering committee convened an international working group (WG). Five consecutive steps were followed: (1) systematic literature review (SLR); (2) discussion of SLR results within the WG and ASAS community; (3) a three-round Delphi survey inviting all ASAS members to select the items that should be considered for the definition; (4) presentation of Delphi results to the WG and ASAS community and (5) ASAS voting and endorsement (2023 annual meeting).
Results Following the SLR, consensus was to proceed with an expert-based definition for early axSpA (81% in favour) but not for pSpA (54% against). Importantly, early axSpA should be based on symptom duration taking solely axial symptoms into account. 151–164 ASAS members participated in the Delphi surveys. Consensus was achieved for considering the following items within early axSpA definition: duration of symptoms ≤2 years; axial symptoms defined as cervical/thoracic/back/buttock pain or morning stiffness; regardless of the presence/absence of radiographic damage. The WG agreed that in patients with a diagnosis of axSpA ‘early axSpA’ should be defined as a duration of ≤2 years of axial symptoms. Axial symptoms should include spinal/buttock pain or morning stiffness and should be considered by a rheumatologist as related to axSpA. The ASAS community endorsed this proposal (88% in favour).
Conclusions Early axSpA has newly been defined, based on expert consensus. This ASAS definition should be adopted in research studies addressing early axSpA.
https://doi.org/10.1136/ard-2023-224232
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Handling editor Josef S Smolen
X @annamolto, @sofiaramiro82
Contributors VN-C and SR designed the study and developed the study protocol. DB and DC performed the survey and summarised the data. All authors participated actively in the project. VN-C and SR wrote the first draft of the manuscript. All authors critically reviewed the manuscript for important intellectual contribution and approved the final version.
Funding The Assessment of SpondyloArthritis international Society (ASAS) funded Diego Benavent to work on this project.
Competing interests VN-C: Speaker fees—AbbVie, Eli Lilly, Janssen, MSD, Novartis, Pfizer, UCB Pharma; Consultancy fees- AbbVie, Eli Lilly, Galapagos, MoonLake, MSD, Novartis, Pfizer, UCB Pharma; Grants: AbbVie, Novartis. DB: Grant/research support from Novartis, and speaker fees from Janssen, Abbvie, and Galapagos. DvdH: Consulting AbbVie, Bayer, BMS, Cyxone, Eisai, Galapagos, Gilead, Glaxo-Smith-Kline, Janssen, Lilly, Novartis, Pfizer, UCB Pharma. Director of Imaging Rheumatology bv. RBML: Consulting AbbVie, Eli-Lilly, Janssen, Galapagos, Gilead, Novartis, Pfizer, UCB. Director of Rheumatology Consultancy BVD. DP: Research grant from AbbVie, Eli Lilly, MSD, Novartis, Pfizer, Consultation AbbVie, Biocad, BMS, Eli Lilly, Gilead, MSD, Novartis, Pfizer, Samsung Bioepis, UCB, Speaker AbbVie, BMS, Lilly, MSD, Novartis, Pfizer, UCB. AvT: Speaker fees: Pfizer; Consulting fees: Novartis, Galapagos, UCB; Grants: Pfizer, UCB, Novartis XB: Abbvie, Amgen, Chugai, Eli Lilly, Galapagos, Janssen, MSD, Novartis, Pfizer, Roche, Sandoz, UCB. FEVdB: received speaker and/or consultancy fees from AbbVie, Amgen, Eli Lilly, Galapagos, Janssen, Moonlake, Novartis, Pfizer and UCB FAvG: Research Grants—Novartis; consultancy -MSD, AbbVie, Novartis and BMS LG: Research grants UCB, Novartis, Consulting fees AbbVie, Acelyrin, Eli Lilly, Fresenius Kabi, Janssen, Novartis, Pfizer, UCB Pharma CL-M: Speaker fees AbbVie, Eli Lilly, Novartis, Janssen, UCB Pharma. Consulting fees Eli Lilly, Novartis, UCB Pharma. HM-O: Speaker fees/consultancy: ABvie, Eli-Lilly, Janssen, Moonlake, Novartis, Pfizer and UCB. Research grants from Janssen, Novartis and UCB. AM: Consulting fees AbbVie, Biogen, BMS, Cyxone, Eisai, Galapagos, Gilead, Janssen, Lilly, Novartis, Pfizer, UCB Pharma. Grants: UCB RP-A: Speaker fees Abbvie, Eli Lilly, Novartis, Janssen, Pfizer. Consulting fees Abbvie, Eli Lilly, Janssen, Novartis. MR: Speaker- AbbVie, Boehringer Ingelheim, Eli Lilly, Janssen, Novartis, UCB Pharma; Consultancy AbbVie, Eli Lilly, Novartis, Pfizer, UCB Pharma MvdS: Speaker -Janssen, Novartis, UCB; Consultancy Abbvie, Eli Lilly, Novartis, UCB; Research Grants: Eli Lily, Novartis, UCB RS: Speaker - AbbVie, Biogen, Eli Lilly, MSD, Novartis, UCB; Consultancy—AbbVie, Eli Lilly, Novartis, Pfizer, UCB. Grants: AbbVie, Novartis, UCB UW: Speaker fees NovartisS. SR: Research Grants—AbbVie, Galapagos, MSD, Novartis, Pfizer, UCB; consultancy—AbbVie, Eli Lilly, MSD, Novartis, Pfizer, Sanofi, UCB.
Provenance and peer review Not commissioned; externally peer reviewed.
Distributions for sex (A), decedents (B), race and ethnicity (C), and dual-eligibility (D). Beneficiary race and ethnicity was determined using the Research Triangle Institute race code; Other and unknown race and ethnicity category includes Asian and Pacific Islander, American Indian or Alaska Native, and any race or ethnicity not otherwise specified. ASR indicates age-standardized rate.
eAppendix. Literature Review Protocol
eTable 1. ICD-10-CM Codes and Prescription Drugs Used in the CCW and 21 Unique Researcher-Developed Claims-Based Dementia Identification Algorithms
eTable 2. Characteristics of Beneficiaries Categorized Into Each Tier of ICD-10-CM Codes (as Defined by Frequency of Use Across the CCW and Researcher-Developed Algorithms) and NDCs
eTable 3 . Raw and Age-Adjusted Characteristics of Beneficiaries Identified as Having Highly Likely ADRD, Likely ADRD, Possible ADRD, and No Evidence of ADRD
eTable 4. Beneficiary Age Distribution in the Full Sample, Within LTC Users and Non-Users, and Within Decedents and Non-Decedents
eTable 5. New Subcodes Associated With F01, F02, and F03 That Went Into Effect in October 2022
eReferences
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Gianattasio KZ , Wachsmuth J , Murphy R, et al. Case Definition for Diagnosed Alzheimer Disease and Related Dementias in Medicare. JAMA Netw Open. 2024;7(9):e2427610. doi:10.1001/jamanetworkopen.2024.27610
© 2024
Question How many Medicare beneficiaries have diagnostic codes or drug prescriptions indicating Alzheimer disease and related dementias (ADRD) using a refined case definition, and what are the characteristics of these beneficiaries?
Findings This cross-sectional study of more than 60 million Medicare beneficiaries identified 7.2% with evidence of highly likely ADRD, 1.9% with likely ADRD, and 4.3% with possible ADRD. Beneficiaries with evidence of ADRD were older, more frail, more likely to use long-term care, and more likely to die than those without evidence of ADRD; these differences persisted after age-standardization.
Meaning In this cross-sectional study, more than 5.4 million Medicare beneficiaries (9.1%) had evidence of likely or highly likely ADRD in 2019; pending validation, this case definition can be adopted provisionally for national surveillance of persons with diagnosed dementia in the Medicare system.
Importance Lack of a US dementia surveillance system hinders efforts to support and address disparities among persons living with Alzheimer disease and related dementias (ADRD).
Objective To review diagnosis and prescription drug code ADRD identification algorithms to develop and implement case definitions for national surveillance.
Design, Setting, and Participants In this cross-sectional study, a systematic literature review was conducted to identify unique International Statistical Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) and prescription drug codes used by researchers to identify ADRD in administrative records. Code frequency of use, characteristics of beneficiaries identified by codes, and expert and author consensus around code definitions informed code placement into categories indicating highly likely, likely, and possible ADRD. These definitions were applied cross-sectionally to 2017 to 2019 Medicare fee-for-service (FFS) claims and Medicare Advantage (MA) encounter data to classify January 2019 Medicare enrollees. Data analysis was conducted from September 2022 to March 2024.
Exposures ICD-10-CM and national drug codes in FFS claims or MA encounters.
Main Outcomes and Measures The primary outcome was counts and rates of beneficiaries meeting each case definition. Category-specific age, sex, race and ethnicity, MA enrollment, dual-eligibility, long-term care utilization, mortality, and rural residence distributions, as well as frailty scores and FFS monthly expenditures were also analyzed. Beneficiary characteristics were compared across categories, and age-standardized to minimize confounding by age.
Results Of the 60 000 869 beneficiaries included (50 853 806 aged 65 years or older [84.8%]; 32 567 891 female [54.3%]; 5 555 571 Hispanic [9.3%]; 6 318 194 non-Hispanic Black [10.5%]; 44 384 980 non-Hispanic White [74.0%]), there were 4 312 496 (7.2%) with highly likely ADRD, 1 124 080 (1.9%) with likely ADRD, and 2 572 176 (4.3%) with possible ADRD, totaling more than 8.0 million with diagnostic evidence of at least possible ADRD. These beneficiaries were older, more frail, more likely to be female, more likely to be dual-eligible, more likely to use long-term care, and more likely to die in 2019 compared with beneficiaries with no evidence of ADRD. These differences became larger when moving from the possible ADRD group to the highly likely ADRD group. Mean (SD) FFS monthly spending was $2966 ($4921) among beneficiaries with highly likely ADRD compared with $936 ($2952) for beneficiaries with no evidence of ADRD. Differences persisted after age standardization.
Conclusions and Relevance This cross-sectional study of 2019 Medicare beneficiaries identified more than 5.4 million Medicare beneficiaries with evidence of at least likely ADRD in 2019 using the diagnostic case definition. Pending validation against clinical and other methods of ascertainment, this approach can be adopted provisionally for national surveillance.
Surveillance is a fundamental public health activity. Lack of a US dementia surveillance system hinders public health efforts to support persons living with Alzheimer disease and related dementias (ADRD), address health disparities, and plan ADRD care resources.
Medicare administrative data are an attractive source upon which to build a dementia surveillance system and are commonly used to identify persons living with ADRD, but a consensus diagnostic code case definition does not exist. Perhaps the most widely used definition (the Centers for Medicare and Medicaid Services [CMS] Chronic Conditions Warehouse [CCW] algorithm) uses 22 International Statistical Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes, from the commonly accepted G30.X (Alzheimer disease) and F01.XX (vascular dementia), to less specific codes such as R54 (age-related physical debility). 1 In contrast, most researcher-developed ICD-10 - CM –based algorithms exclude R54, but may include codes such as G31.0 (frontotemporal dementia) that are not in the CCW algorithm. 2 - 4 Moreover, while some algorithms use Medicare Part D data to identify prescriptions for Alzheimer disease–related drugs, 5 - 8 most do not.
The impact of using different ICD-10-CM or prescription codes on the number of people identified or their characteristics is unknown. Because ICD-10-CM codes are used for billing (rather than diagnostic) purposes, specific codes may not be sensitive nor specific to dementia, and coding practices may differ systematically by health care practice, patient characteristics, and geography.
We examined how choices of ICD-10-CM and prescription drug codes used to identify persons with clinically recognized ADRD in Medicare fee-for-service (FFS) claims and Medicare Advantage (MA) encounter data affect dementia prevalence estimates and characteristics of the people identified. We synthesized this information to develop a new case definition using diagnostic and prescription drug codes that can be applied to administrative data to support surveillance of persons with diagnosed dementia in the Medicare system.
This cross-sectional study was deemed exempt from review and the requirement of informed consent by the NORC Institutional Review Board. The reporting of this research follows the Strengthening the Reporting of Observational Studies in Epidemiology ( STROBE ) reporting guideline.
We searched PubMed for articles published from 2012 to 2022, with all-cause dementia or ADRD as a primary exposure or primary outcome, or where the research population of interest was persons living with all-cause dementia or ADRD (eAppendix in Supplement 1 ). We found 28 studies utilizing 20 distinct researcher-developed ICD-10-CM or prescription drug code algorithms in addition to the CCW algorithm (eTable 1 in Supplement 1 ). 2 - 21
We extracted 43 ICD-10-CM codes and 5 prescription drugs across algorithms ( Table 1 and eTable 1 in Supplement 1 ). We shared the codes with 3 clinicians (2 neurology clinicians and 1 geriatrics clinician) who provide care to persons living with dementia, who recommended excluding 8 codes deemed to not indicate dementia ( Table 1 ). We grouped the remaining codes into tiers by use frequency (tier 1, ≥15 algorithms; tier 2, 10-14 algorithms; tier 3, 5-9 algorithms; and tier 4, 1-4 algorithms). We designated prescriptions for ADRD-targeting drugs as indicated by National Drug Codes (NDC) without presence of an ADRD ICD-10-CM code as tier 5.
We used 100% of the 2017 to 2019 Medicare FFS inpatient, outpatient, carrier, skilled nursing facility, home health agency, and hospice claims; MA inpatient, outpatient, carrier, skilled nursing facility, and home health agency encounter data; and Medicare Part D prescription drug event (PDE) data. We used the minimum dataset (MDS 3.0) to identify long-term care (LTC) utilization. We limited analysis to Medicare beneficiaries with at least Part A (the premium-free Medicare benefit) enrollment in January 2019, nonmissing sex, and a valid US state or territory code based on the Medicare beneficiary summary files. We did not exclude beneficiaries based on age or lack of Part B enrollment because our aim was to identify all people in the Medicare system with evidence of ADRD.
To categorize beneficiaries with or without evidence of dementia as of 2019, we conducted a cross-sectional analysis of January 2017 to December 2019 FFS and MA data to identify all claims and encounters with a relevant ICD-10-CM code listed in any position, and all PDE claims for a relevant NDC. We classified beneficiaries hierarchically, first with a tier 1 ICD-10-CM code, then with a tier 2 code among remaining beneficiaries, and so on, identifying only the incremental beneficiaries in each tier if they had not been classified earlier. We compared distributions of age, sex, race and ethnicity (as indicated by the Research Triangle Institute race code 22 ), MA enrollment, LTC use, and 2019 mortality across tiers. Race and ethnicity categories included American Indian or Alaska Native, Asian or Pacific Islander, Hispanic, non-Hispanic Black, non-Hispanic White, unknown, and other (defined as any race or ethnicity not otherwise specified); race and ethnicity were included because existing evidence shows that there are disparities in dementia prevalence across race and ethnicity groups. We compared cross-tier beneficiary frailty using a claims-based frailty index (CFI), 23 an adapted CFI that excludes ADRD codes in tiers 1 to 4, and per-member-per-month (PMPM) spending, averaged across all months of 2019 FFS coverage.
Using these data (eTable 2 in Supplement 1 ), we found that beneficiaries in tiers 1 and 2 were older, more frail, more likely to be female, in LTC, and die than those in tiers 3 to 5. There were minimal differences in race and ethnicity across tiers, with exception of a higher-than-expected representation of Hispanic and Asian and Pacific Islander beneficiaries in tier 5; however, the overall size of the sample categorized as tier 5 was very small, at just 0.1% (52 338 of 60 000 869 beneficiaries). Based on the findings from the cross-tier comparison and author consensus, we further aggregated codes into 3 categories with decreasing confidence of having a true ADRD diagnosis: a highly likely ADRD category requiring at least 2 claims or encounters on different dates with ICD-10-CM codes from tiers 1 or 2; a likely ADRD category requiring 1 claim or encounter with an ICD-10-10-CM code from tiers 1 or 2; and a possible ADRD category requiring at least 1 claim or encounter with an ICD-10-CM or NDC code from tiers 3, 4, or 5 over a 3-year lookback period. We categorized beneficiaries and reevaluated group demographics, health insurance type, frailty and mortality, and rural residency. We then computed prevalence of highly likely, likely, and possible ADRD within population subgroups defined by these characteristics. We age-standardized to the full analytical population to evaluate differences unconfounded by age.
All analyses were conducted in SAS Enterprise Guide 7.1 and SAS Studio version 3.81 (SAS Institute). Data analysis was conducted from September 2022 to March 2024.
Of 64 430 729 2019 Medicare beneficiaries, we excluded 3 940 831 due to lack of Part A enrollment in January, 8 due to missing sex, and 489 021 due to a nonvalid US state or territory code, resulting in a total of 60 000 869 beneficiaries (50 853 806 aged 65 years or older [84.8%]; 32 567 891 female [54.3%]; 5 555 571 Hispanic [9.3%]; 6 318 194 non-Hispanic Black [10.5%]; 44 384 980 non-Hispanic White [74.0%]) included in the study sample. Of all beneficiaries, 11 502 479 (19.2%) had Medicaid dual-eligibility, while 23 607 426 (39.3%) had MA. Mean (SD) FFS PMPM spending in 2019 was $1220 ($3426) ( Table 2 ).
We identified 4 312 496 beneficiaries (7.2%) as having highly likely ADRD, and 1 124 080 (1.9%) as having likely ADRD ( Table 3 ). The proportion of beneficiaries with highly likely ADRD increased to 8.1% (4 125 639 beneficiaries) after limiting age to 65 years or older, and to 8.8% (4 093 008 beneficiaries) when further limiting to those with both Parts A and B enrollment. The proportion of beneficiaries with likely ADRD increased to 2.1% (996 379 beneficiaries) after these restrictions. Compared with those with likely ADRD, those with highly likely ADRD were older and more frail, more likely to be female and dual-eligible, had over 3 times the rate of LTC utilization (681 923 of 4 312 496 beneficiaries [15.8%] vs 51 332 of 1 124 080 beneficiaries [4.6%]), and almost double the rate of death (828 366 of 4 312 496 beneficiaries [19.2%] vs 129 705 of 1 124 080 beneficiaries [11.5%]). We identified an additional 2 572 176 beneficiaries (4.3%) as having possible ADRD; this percentage increased to 4.8% (2 231 673 beneficiaries) after restricting to beneficiaries aged 65 years or older with Parts A and B enrollment. The possible ADRD group was younger and healthier (lower CFI, mortality, and LTC utilization) than those with highly likely or likely ADRD but was older and less healthy than those with no evidence of ADRD (51 992 117 beneficiaries). Mean (SD) PMPM spending was approximately 3 times as high in the ADRD groups (ranging from $2559 [$2952] among those with possible ADRD to $2966 [$4921] among those with highly likely ADRD) as that of the no ADRD group ($936 [$2952]). Age standardization narrowed differences in sex distribution and death rates, widened differences in race and ethnicity distribution and dual-eligible rates, and had minimal impact on differences in MA enrollment, LTC utilization, and frailty ( Figure and eTable 3 in Supplement 1 ). FFS spending increased slightly for all categories after age standardization.
The proportion of beneficiaries with any evidence of ADRD increased with age, from 6.5% (1 931 517 of 29 878 739 beneficiaries) among beneficiaries aged 65 to 74 years to 42.5% (2 544 205 of 5 983 967) among those aged 85 years or older, with the largest increase seen in the percentage of those with highly likely ADRD (2.6% [770 296 of 29 878 739 beneficiaries] to 29.1% [1 739 705 of 5 983 967 beneficiaries]) ( Table 4 ). Prevalence of any ADRD was higher in females than in males but was similar between non-Hispanic White (5 950 598 beneficiaries [13.4%]), non-Hispanic Black (892 541 beneficiaries [14.1%]), and Hispanic (792 948 beneficiaries [14.3%]) beneficiaries. Those with LTC use were substantially more likely to have ADRD than those with no LTC (681 923 of 937 248 beneficiaries [72.8%] vs 3 630 573 of 59 063 621 beneficiaries [6.1%] categorized as highly likely). Similarly, prevalence of highly likely or likely ADRD was much higher in decedents (958 071 of 2 285 257 beneficiaries [41.9%]) than nondecedents (4 478 505 of 57 715 612 beneficiaries [7.7%]) and in those who were dual-eligible (1 917 434 of 11 502 479 beneficiaries [16.7%]) than among those who were not (3 519 142 of 48 498 390 beneficiaries [7.2%]). MA beneficiaries had a higher prevalence of highly likely or likely ADRD (2 296 154 of 23 607 426 beneficiaries [9.7%]) than FFS beneficiaries (3 140 422 of 36 393 443 beneficiaries [8.6%]), and any evidence of ADRD (4 595 211 of 23 607 426 beneficiaries [14.5%] for MA vs 4 593 211 of 36 393 443 beneficiaries [12.6%] for FFS).
Age-standardizing subgroups to the age distribution of the Medicare population resulted in changes in ADRD prevalence estimates in some groups ( Table 4 ). Relative differences in ADRD prevalence narrowed across sex but widened across race and ethnicity groups. Most notably, non-Hispanic White beneficiaries became less likely to have any evidence of ADRD (12.9% across categories), while racial and ethnic minority groups became more likely to have evidence of ADRD (non-Hispanic Black beneficiaries, 16.5%; Hispanic beneficiaries, 15.3%). Among non-Hispanic Black beneficiaries, age standardization resulted in a substantial increase in the proportion of those with highly likely or likely ADRD (9.9% to 12.0%). Age standardization also reduced ADRD prevalence among LTC users (from 72.8% to 62.8% with highly likely ADRD) and decedents (from 36.2% to 23.8% with highly likely ADRD) but had minimal impact in ADRD prevalence among non–LTC users and nondecedents; this is because LTC-users and decedent groups were heavily skewed toward older ages, while the age distribution of the non–LTC users and nondecedent groups mimicked that of the general Medicare population (eTable 4 in Supplement 1 ).
Among 2019 Medicare beneficiaries in this cross-sectional study, we identified approximately 4.3 million (7.2%) with highly likely ADRD, 1.1 million (1.9%) with likely ADRD, and 2.6 million (4.3%) with possible ADRD, for a total of more than 8.0 million (13.4%) in any category. Specifically, we developed new diagnosis and NDC code ADRD case definitions informed by a systematic review of previous algorithms, author and expert input, and analyses of Medicare data. The review identified 43 ICD-10-CM codes and 5 prescription drugs used by the CCW and 20 researcher-developed algorithms to identify ADRD in Medicare data. We divided codes into categories that were likely to indicate ADRD vs those that were possibly ADRD based on past frequency of use by other researchers, characteristics of beneficiaries identified by codes, and author and expert consensus around code definitions. We then added a highly likely category to describe beneficiaries who received 2 or more likely codes on different dates of service. We posit that these categories are superior to previous definitions for provisional use in surveillance systems, but caution that validation is necessary. To our knowledge, this is the first application of claims identification algorithms to all-age FFS and MA beneficiaries. We have used this case definition to compute provisional national-, state-, and county-level estimates of ADRD prevalence and incidence in 2020 Medicare and published them on our dementia surveillance website. 24 Estimates will be refined pending validation and updated with additional years of data as they become available.
Our 3-level case definition is novel in that it was driven by researcher-consensus as well as data analysis and identifies dementia with varying degrees of certainty. Of note, ICD-10-CM codes used to identify possible ADRD have lower researcher consensus and less specific code descriptions (ie, do not contain dementia or Alzheimer ). Use of the possible ADRD codes may reflect physician uncertainty about a dementia diagnosis or medical events involving ADRD-like symptoms in patients without underlying dementia. 25 - 27 Our definition also excludes several previously used codes that were determined to not indicate ADRD by expert clinicians. Compared with the commonly used CCW algorithm, which similarly uses a 3-year look-back period, our case definition is more specific when limited to the highly likely and likely categories, but broader when also including the possible ADRD category. The CCW algorithm estimated prevalence of 10.7% in 2019 Medicare FFS beneficiaries 28 falls between our estimates for FFS beneficiaries of 8.6% for highly likely or likely ADRD and 12.6% for all 3 categories.
Importantly, we saw expected and meaningful differences between beneficiaries identified in each ADRD category. Moving from the no evidence of ADRD to the highly likely ADRD groups, beneficiaries became progressively older and more frail and had greater rates of dual-eligibility, LTC use, and death, which is consistent with prior research. 29 - 35 Notably, prevalence of highly likely ADRD was 29.1% in beneficiaries aged 85 years or older, 72.8% in LTC users, and 36.2% in decedents, compared with 7.2% in the general Medicare population. Higher rates of dual-eligibility in ADRD groups may be driven by ADRD beneficiaries spending down assets to qualify for Medicaid and obtain LTC coverage. These differences persisted after age standardization and lend confidence to our case definitions.
Application of our case definitions also showed disparities in diagnosis rates by race in the expected direction—higher dementia risk among non-Hispanic Black beneficiaries relative to non-Hispanic White beneficiaries 36 , 37 —after age standardization to account for lower life expectancy among non-Hispanic Black individuals. 38 However, because non-Hispanic Black individuals also have a greater risk of under-diagnosis of ADRD than non-Hispanic White individuals, 39 disparities in true underlying rates may be higher than observed. Additionally, we found higher-than-expected representation of Hispanic and Asian and Pacific Islander beneficiaries among those that had an ADRD-targeting drug without diagnostic ( ICD-10-CM ) evidence. We hypothesize that differences in cultural perceptions around dementia and cognitive decline (eg, memory loss as a normal aging process) 40 , 41 may result in lower utilization of diagnosis codes when providers suspect dementia. Using PDE claims may result in higher and more accurate rates of ADRD among Hispanic and Asian and Pacific Islander individuals despite the overall small number of beneficiaries identified by PDE claims alone.
Finally, also consistent with past research, 29 , 35 , 42 PMPM FFS spending was substantially higher for beneficiaries with evidence of ADRD compared with those with no evidence of ADRD. Medicare FFS PMPM spending was relatively similar across the highly likely, likely, and possible ADRD groups despite differences in frailty and mortality. Medicare FFS spending may not be generalizable to those with MA (for whom costs cannot be computed) and is only part of the economic story. Medicaid is the primary US payer of LTC; higher rates of dual-eligibility and LTC use among the highly likely ADRD group indicate that differences in total federal and state spending between the highly likely ADRD and other groups are likely larger. We also did not capture patient and family health–related out-of-pocket expenses and informal care costs ($203 117 in families caring for a patient living with dementia vs $102 955 in families caring for a patient without dementia over the last 7 years of the patient’s life 42 ), forgone wages, or other impacts on informal caregivers, and payments made by other assistance programs. Finally, we caution that our spending measure represents total Medicare FFS spending, rather than the incremental ADRD costs.
This study is limited by at least the following. First, our ADRD case definition was driven by researcher-consensus, and validation against other dementia ascertainment methods (including ascertainment based on in-person clinical and neuropsychological assessments) is necessary. Both over- and under-diagnosis of ADRD have been documented in Medicare claims, 35 , 39 and the 8.0 million beneficiaries identified as having some evidence of ADRD by our case definition will include some without ADRD, especially those in the possible category. Similarly, this method only captures documented cases of dementia in Medicare administrative records and cannot capture beneficiaries with unrecognized and/or undocumented ADRD. If we assume a 60% rate of undetected dementia in the US 43 our estimates would suggest an additional 12 million beneficiaries may be living with ADRD. Additionally, our data show a marginally higher rate of ADRD in MA than in FFS enrollees (14.5% vs 12.6% across the 3 categories), which may reflect beneficiary selection in MA plans, MA vs FFS differences in clinical ADRD assessment and diagnosis rates, differences in claims or encounter documentation, or a combination thereof. Given the rapid rise in MA participation (from 33% in 2017 to 51% in 2023) and variation in MA penetration across counties, 44 , 45 it is also important to understand potential differences in performance of this case definition between MA and FFS beneficiaries. As such, validation of this case definition against in-person clinical and other ascertainment methods to assess performance (including sensitivity, specificity, positive predictive value, and negative predictive value), separately for Medicare FFS and MA, is critical for refining and calibrating estimates to accurately capture the diagnosed prevalence and incidence of dementia. Pending validation, our case definitions should be considered provisional. Notably, we expect the possible ADRD category to identify a higher proportion of individuals who do not have ADRD. Thus, it is important to report the possible ADRD category separately from the likely and highly likely ADRD categories in research and surveillance efforts using these case definitions.
Second, evidence for ADRD documented in electronic health or insurance records outside the Medicare system is not captured by our method; this is particularly problematic for beneficiaries without Medicare Parts B or D (7.5% and 25.6% of Medicare enrollees, respectively 43 , 46 ). Third, we deliberately used data from 2017 to 2019 to avoid the COVID-19 pandemic years, which resulted in secular shocks, including excess senior deaths, forgone or deferred care, and increased telehealth, which may have impacted dementia diagnosis. Research is necessary to understand these effects but will necessarily be delayed pending new data. Fourth, Namzaric, a memantine and donepezil combination drug approved in 2014, was not included by any prescription-drug based identification strategy; while the impact of including this drug necessitates further investigation, we anticipate a negligible effect given that just 0.1% of the sample had an ADRD-targeting prescription drug without ICD-10-CM evidence. Similarly, ICD-10 -CM code updates from October 2022 added 29 highly specific codes each under code roots F01 (vascular dementia) F02 (dementia in other diseases classified elsewhere), and F03 (unspecified dementia) (eTable 5 in Supplement 1 ). 47 We recommend that applications of our approach to Medicare records beginning in October 2022 include these for identifying highly likely and likely ADRD. Fifth, in developing our case definitions, we only considered use of ICD-10-CM codes and prescription drugs but did not consider other criteria of existing ADRD-identification algorithms, including look-back period, types of claims or encounter data considered, number of claims or encounters with relevant ICD-10-CM codes required, and time elapsed between claims and encounters; sensitivity analyses around these different criteria are beyond the scope of this paper.
In this cross-sectional study, our novel case definition for ADRD identified approximately 5.4 million Medicare beneficiaries with evidence of at least likely ADRD in 2019. Pending validation against in-person clinical and other ascertainment methods, this definition can be adopted for provisional use in national surveillance efforts.
Accepted for Publication: June 17, 2024.
Published: September 3, 2024. doi:10.1001/jamanetworkopen.2024.27610
Open Access: This is an open access article distributed under the terms of the CC-BY License . © 2024 Gianattasio KZ et al. JAMA Network Open .
Corresponding Author: Kan Z. Gianattasio, PhD, NORC at the University of Chicago, 4350 East-West Hwy 8th Floor, Bethesda, MD 20814 ( [email protected] ).
Author Contributions: Mr Wachsmuth and Mr Murphy had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Gianattasio, Hartzman, Wittenborn, Power, Rein.
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: Gianattasio, Wachsmuth, Hartzman, Cutroneo, Wittenborn, Rein.
Critical review of the manuscript for important intellectual content: Gianattasio, Murphy, Hartzman, Montazer, Power, Rein.
Statistical analysis: Gianattasio, Wachsmuth, Murphy.
Obtained funding: Wittenborn, Rein.
Administrative, technical, or material support: Hartzman, Montazer, Cutroneo.
Supervision: Hartzman, Rein.
Conflict of Interest Disclosures: None reported.
Funding/Support: Research reported in this publication was supported by the National Institute on Aging of the National Institutes of Health (Award No. R01AG075730).
Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Data Sharing Statement: See Supplement 2 .
Additional Contributions: We would like to thank Christina Prather, MD (George Washington University); Tania Alchalabi, MD (George Washington University); and Raymond Scott Turner, MD, PhD (Georgetown University), for providing critical review of the International Statistical Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes from a clinical perspective. Drs Prather, Alchalabi, and Turner did not receive compensation for their contributions to this work. We also wish to acknowledge the critical input into data processing and analysis decisions made by Qian Gu, PhD (KPMG); Carrie Bao, BS (KPMG); and Samuel Knisely, BA, (KPMG). Dr Gu, Ms Bao, and Mr Knisely received funding from the same National Institute on Aging grant (R01AG075730) that funded this study for their input.
Vice President Kamala Harris’ economic policy plans include a backing of President Joe Biden’s proposal to tax unrealized capital gains on the U.S.’ richest people, a plan unsurprisingly denounced by former President Donald Trump and his associates, though some criticism of the plan is rooted in misinformation.
Kamala Harris speaks at the National Forum on Wages and Working People: Creating an Economy That ... [+] Works for All in Las Vegas in 2019.
The Democratic presidential nominee supports a plan first introduced in 2022 by Biden to impose a 25% minimum tax on unrealized capital gains accrued by Americans with net worths of $100 million or more, according to the Biden administration’s latest 2025 tax proposal released in March—which would alter a fundamental principle of how capital gains are taxed in the U.S., but only affect a small fraction of America’s wealthiest population.
As a refresher, capital gains taxes currently only apply to physical and financial assets, such as real estate properties, shares in publicly traded companies and jewelry, which were sold at a profit and thus are taxed as income.
That means the affected individuals would pay taxes on assets that appreciated in value through a year, even if they did not sell, bucking the current standard that only charges capital gains taxes on profits tallied from those assets.
For example, if the world’s richest man Elon Musk saw his $102 billion stake in Tesla at the end of 2023 rise to $122 billion by year’s end due to an increase in Tesla’s share price, he would pay taxes on the $20 billion increase in the value of his Tesla stock; current tax code requires he would have only had to pay capital gains tax if he actually offloaded his shares in the electric vehicle company.
Far less than .01% of taxpayers cleared the $100 million net worth threshold to pay unrealized capital gains taxes as just 9,850 Americans were worth that amount or more at the end of 2023, according to estimates from Henley & Partners and New World Wealth.
Still, recent viral social media posts falsely claim the proposal will cause everyday Americans worth far below the threshold to feel impacts—the median American family has a net worth of $192,900, according to the Federal Reserve’s most recent data. Trump claimed at an Aug. 23 rally the Harris proposal on unrealized capital gains will impact “small business owners” who will be forced to sell their “restaurant immediately,” a seemingly misguided statement considering the small group the plan would impact. Trump allies have panned the proposal: Musk said it’s part of a policy plan that will lead to “bread lines” and billionaire venture capitalist Marc Andreessen said founding startups in the U.S. would become “completely implausible” due to the perceived disincentivization the proposed taxes would have for founders looking to build massive fortunes. The unrealized capital gains tax is “one of the worst tax ideas floating around,” Jay Clayton, commissioner of the Securities and Exchange Commission under Trump, told CNBC on Tuesday.
The Biden administration estimates the unrealized capital gains tax would generate about $503 billion in tax revenue from the government’s 2025 to 2034 fiscal years. Experts suggest it’s unlikely the proposal makes much headway in Washington, considering Biden failed to pass the proposal when Democrats controlled both chambers of Congress from 2021 to 2023 and the headaches policymakers would have in enforcement. Several experts identified the issue that determining what actually qualifies as unrealized capital gains is a challenging exercise considering it’s not based on actual transactions, creating a “very onerous process,” Raymond James’ chief investment officer Larry Adam recently told Yahoo Finance.
The idea of taxing the U.S.’ richest residents is generally popular, and a 2022 YouGov survey found 57% of Americans believe billionaires don’t pay enough in taxes. A 2021 White House study found billionaires on Forbes’ annual list of the 400 richest Americans paid an effective average federal tax rate of 8.2% from 2010 to 2018, using a methodology including unrealized capital gains, far below the average federal income tax of more than 18% during the period, according to Tax Policy Center.
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When you cut your way through all of the highly divisive political rhetoric surrounding this year’s election , you find there is actually common ground in some policy areas, especially when it comes to economic policy.
And there is some — emphasis on some — limited bipartisan focus on policies that aim to support families raising children. One factor behind this interest in so-called “care proposals” may be a shift in economic research interested in measuring not just what happens to caregivers and parents when they get support for their families, but the long-run effects on how these children fare as they grow up.
For more on this, “Marketplace Morning Report” host Sabri Ben-Achour spoke with Marketplace’s senior economics contributor Chris Farrell. Below is an edited transcript of their conversation.
Sabri Ben-Achour: So just how much agreement do you see across party lines when it comes to economic support for families with kids?
Chris Farrell: There are deep divisions in the best ways to help struggling families and their children. But there does seem to be more child-centric initiatives in-play on both the federal and state level. Republican Vice Presidential candidate JD Vance says he’d like to more than double the current federal child tax credit to $5,000. Democratic Presidential candidate Kamala Harris wants families with a newborn to get a $6,000 child tax credit and to boost the credit for other kids in the family . Now, the details differ in important ways, of course, but the shared emphasis, it’s intriguing.
Ben-Achour: Sometimes when there is a consensus on something in research, it does not necessarily translate to a consensus in politics on that issue. So I’m wondering, why do you think there is this slight alignment on the issue of children and families?
Farrell: Economist and blogger Noah Smith , he notes that economic paradigms are more important as ways of thinking about policy, rather than a list of actual policies. And I thought about that framing while reviewing a National Bureau of Economic Research program report on a conference on children and families. And the report notes that historically, research largely focused on the risk that unconditional support for low-income families it might sustain rather than alleviate poverty.
Ben-Achour: That idea is something I remember hearing in decades past. You know, the idea that that helping people disincentivizes them from working. Does that actually hold any water when you look at it?
Farrell: You know many researchers these days, they find little effect on labor supply or marriage rates from safety net programs. Instead, academic research now puts a greater emphasis on investigating the long-term impact of safety net programs on children and their human capital development. And the research agenda in recent years has shown, and I quote from the summary, significant positive effects of safety net programs on short-run children outcomes , as well as longer term measures.
Ben-Achour: So if there has been a shift in the focus of economic research focusing on the cost of caregiving, the potential gains for children from public policy, do you think that politicians are registering that and trying to fix it?
Farrell: My sense is that everyone acknowledges that parents and families are really stretched. The kind of research we’re talking about, it’s an inspiration for ideas and policies with the best chance of healthy human capital development for children from families that live on low and unstable incomes.
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The vice president supports the tax increases proposed by the Biden White House, according to her campaign.
By Andrew Duehren
Reporting from Washington
In a campaign otherwise light on policy specifics, Vice President Kamala Harris this week quietly rolled out her most detailed, far-ranging proposal yet: nearly $5 trillion in tax increases over a decade.
That’s how much more revenue the federal government would raise if it adopted a number of tax increases that President Biden proposed in the spring . Ms. Harris’s campaign said this week that she supported those tax hikes, which were thoroughly laid out in the most recent federal budget plan prepared by the Biden administration.
No one making less than $400,000 a year would see their taxes go up under the plan. Instead, Ms. Harris is seeking to significantly raise taxes on the wealthiest Americans and large corporations. Congress has previously rejected many of these tax ideas, even when Democrats controlled both chambers.
While tax policy is right now a subplot in a turbulent presidential campaign, it will be a primary policy issue in Washington next year. The next president will have to work with Congress to address the tax cuts Donald J. Trump signed into law in 2017. Many of those tax cuts expire after 2025, meaning millions of Americans will see their taxes go up if lawmakers don’t reach a deal next year.
Here’s an overview of what we now know — and still don’t know — about the Democratic nominee’s views on taxes.
The most recent White House budget includes several proposals that would raise taxes on large corporations . Chief among them is raising the corporate tax rate to 28 percent from 21 percent, a step that the Treasury Department estimated could bring in $1.3 trillion in revenue over the next 10 years.
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COMMENTS
What Is A Research Proposal? Examples + Template
Organizing Your Social Sciences Research Paper
Overview. A research proposal is a type of text which maps out a proposed central research problem or question and a suggested approach to its investigation. In many universities, including RMIT, the research proposal is a formal requirement. It is central to achieving your first milestone: your Confirmation of Candidature.
How to Write a Research Proposal | Examples & ...
The best research proposal definition states that it is a structured document that describes an intended study. This formal document reveals the importance and methodology of conducting the ...
A range of skills and expertise is needed for the task of proposal writing as well as for the research that follows a successful application. Therefore this book is intended to help those who are unfamiliar with the process of proposal writing or who want to improve their chances of success in a complex and demanding field.
A research proposal is a formal document expressing the details of a research project, which is usually for science or academic purposes, and it's typically four to seven pages long. Research proposals often include a title page, an abstract, an introduction, background information, research questions, a literature review and a bibliography.
Research proposal
How to write a research proposal? - PMC
What is a research proposal?
Guidelines for Writing Research Proposals and Dissertations
Let us pretend we are doing research on nurturing international business research through global value chains literature. You do not need to include definitions for research, business, international, global, etc. These terms are common knowledge and are mostly understood the same way by everyone.
How to Write a Research Proposal in 2024: Structure ...
Parts of a Research Proposal - Writing a Research Proposal
11.2 Steps in Developing a Research Proposal
Answer: A research proposal should flow similarly to a research paper. This is the general order of how content should be structured in a research. proposal (McCombes, 2019): Cover Page: Contains ...
GUIDELINES FOR WRITING RESEARCH PROPOSALS
Research Proposal 6 - How to Write the Definitions of Terms
17 Research Proposal Examples (2024)
(PDF) RESEARCH PROPOSAL
Project 2025 - Wikipedia ... Project 2025
In her campaign for president, VP Kamala Harris has embraced all the tax increases President Biden proposed in the White House FY 2025 budget—including a new idea that would require taxpayers with net wealth above $100 million to pay a minimum tax on their unrealized capital gains from assets such as stocks, bonds, or privately held companies.
He says that the proposal is designed "to address substantial inequities in our tax system," whereby the wealthiest often pay lower rates than do the regular rich and middle class. The old Warren Buffett vs. his secretary argument. The fact that it also is projected to raise $500 billion over 10 years was important, but secondary, to Biden.
Objectives To develop a consensual definition for the term 'early axial spondyloarthritis—axSpA'—and 'early peripheral spondyloarthritis—pSpA'. Methods The ASAS (Assessment of SpondyloArthritis international Society-Spondyloarthritis EARly definition) steering committee convened an international working group (WG). Five consecutive steps were followed: (1) systematic literature ...
A new television ad from former President Donald Trump's campaign piles deception upon deception to attack Vice President Kamala Harris on immigration.The ad uses an edited quote to attack ...
Key Points. Question How many Medicare beneficiaries have diagnostic codes or drug prescriptions indicating Alzheimer disease and related dementias (ADRD) using a refined case definition, and what are the characteristics of these beneficiaries?. Findings This cross-sectional study of more than 60 million Medicare beneficiaries identified 7.2% with evidence of highly likely ADRD, 1.9% with ...
Topline. Vice President Kamala Harris' economic policy plans include a backing of President Joe Biden's proposal to tax unrealized capital gains on the U.S.' richest people, a plan ...
The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered ... ," "principal," "proposal," and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. ... Conducing market research to identify small ...
A shift in economic research is focused on the longer-term outcomes for children in families who receive government support. ... One factor behind this interest in so-called "care proposals ...
In a campaign otherwise light on policy specifics, Vice President Kamala Harris this week quietly rolled out her most detailed, far-ranging proposal yet: nearly $5 trillion in tax increases over a ...