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Research methodology 101
- 1. Pitfalls in Studies Models from Literature
- 2. now You know Clinical Expertise Best Research Evidence Patient Values EBP
- 3. Now you know where to search for evidence using the study design hierarchy of evidence. systematic reviews Prospective controlled trial Cohort trial Case series studies Expert opinion RCT
- 36. Estimate of effect is graphically displayed as the midline of the blob or square Confidence interval (CI) shows the range within which the true size of effect of intervention is likely to lie Overall effect size This denotes the overall statistical result.
- 40. Thank You
Notes de l'éditeur
- Practicing EBM requires the integration of best research evidence with clinical expertise and patient values. This includes clinically relevant patient centered research about the accuracy and precision of diagnostic tests, the harms and benefits of therapies and the prognosis of patients with certain diseases. This information must be both valid and relevant. The best evidence must be integrated with the clinical expertise of the physician. With each patient encounter, the physician becomes more proficient at different diagnoses and treatments. Finally, the patient’s values must be integrated into the treatment plan. Decisions about care are modified by the patient’s beliefs, understanding of issues, preferences and expectations.
- When doing a search to answer a question, one wants to find the best evidence first. This pyramid offers a concept of checking Cochrane clinical evidence and other secondary pre-appraised literature first, both for the quality of information that can be found as well as speed with which one can find information.
- Hey there, does this list of steps sound familiar with all you instruction folk out there? Or any of you who have conducted a class session on research basics? Yes! It’s the same basic plan. It was when you were writing your first research paper in high school and college and it’s the same plan now. Finding the right topic can seem like a daunting task but we’ll show you some ways to make that step easier. After that you need to figure out just what your research focus really is, and that’s often done in the form of a question. Next, or even simultaneously, you should define your population of study. Students? Faculty? Users in your library? Which users? On to the next step of deciding your research design as well as deciding on your research instrument. You might ask yourself, “Am I going to conduct a survey? Via the web? E-mail? In person? Mail in? Will I interview people? Will I use a published measurement or scale? Will I do a pre and post test study?” Next you need to put your research plan into action by gathering your data set. Maybe you are collecting transaction logs from your web site or from your catalog or maybe you are doing classroom research so you are collecting data from your students over many semesters to do a learning outcomes assessment study. Next, you need to interpret what you have found. This step takes a little time and more than a lot of thought. Finally, you should write up your findings. Think of it as telling a story about what you did and what you found out. Simple? No? Fun? Sometimes~ Long term rewards? Priceless!
- You should try to avoid some typical problems that befall researchers. One of these is found in population. First of all is your sample representative of what you are trying to study? How did you arrive at your sample? Did you not exclude those that need to be included or did you include those that shouldn’t be included. Let’s look at some of those research problems we looked at in the beginning of this session.
- It’s important to thoroughly define what you are measuring and how you are measuring it otherwise you may run into some problems.
- Explain that in studies of the effects of health care, the “estimate of effect” is the observed relationship between an intervention and an outcome. Tell participants that calculations for the OR and RR are contained at the end of the session in their Manuals.
- If the OR = 1, the intervention has no effect. With respect to the event being measured, there is no difference between the control group and the group receiving the intervention. Another way of saying this is that the ratio of the number of people in a group with an event to the number without an event is equal to one.
- Remind the participants that “relative risk” is one of the measures of effect that is reported in studies of the effects of health care.
- A 95% confidence interval (95% CI) can broadly be translated to mean that if the trial was to be repeated 100 times with all factors remaining identical, a result (estimate of effect) which lay within the range of the CI will be found in 95% of cases . A 99% confidence interval (99% CI) can thus broadly be translated to mean that if the trial was to be repeated 100 times with all factors remaining identical, a result (estimate of effect) which lay within the range of the CI will be found in 99% of cases .
- Explain that the number needed to treat is a useful way of looking at results of reviews or trials because it expresses the therapeutic effort that is needed to get a therapeutic result. Increasingly we have choices of treatments, and the NNTs should help us make the choice that is right for an individual patient. It is calculated from the relative risk. For trainer information only: NNT = 1 / Risk difference Risk difference = Incidence in exposed – Incidence in unexposed
- Explain that a “ meta-analysis ” is a statistical procedure that integrates the results of several independent studies that can be “combined”. It provides a quantitative summary of the overall effect of the intervention (a pooled estimate and a confidence interval). Please stress that: a systematic review can stand alone without a meta-analysis should the individual studies be too diverse to combine statistically. the main requirement for a worthwhile meta-analysis is a well-executed systematic review.