Research methology intro_ YL

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  • Undertaken in most professions More than a set of skills Way of thinking ; critical examine the various aspects of your work, understand how things work, developing and testing new theories to enhance your profession. Becomes a habit – a habit of questioning Questions can be raised about any professioons – as long as you either directly or indirectly provide service
  • Informal Clinical impression/judgement Philosophy – higher aim – bring benefit to others. Positivenism and naturalnism Valid and reliable – measurements Unbiased and objective – no personal vested interest
  • 2 syllables ; re – search , former – prefix – again, anew or over again Latter – verb – to examine closely and carefully, to test or try, or to probe
  • The setting = Labs The subjects = human tissues/genes, specimens etc
  • The setting = ideal population/community (house to house ) The subjects = community members Topics of study include describing new diseases, Descibe how diseases are spread (aetiology/risk factors) Decsribe methods to preventing the spread of disease, etc.
  • There are health services researchers who conduct research on how health care is delivered to people. Topics of study include how health services are paid for, who does and does not get care, where people get care, what types of treatment are most effective, etc. In both instances, results of the research are used to develop health policy that seeks to protect and ensure the Public’s Health.
  • rule discriminatory value of sign and symptom, diagnostic test accuracy study developing and validating new instrument eg risk factor modelling
  • Think of 1 research question: Are patients satisfied with our OP counter-service? – target : patients who use OP in IPR, satisfaction level
  • Intended sample : patients coming to OP IPR from jan- mac 2008, patients satisfaction scale questionnaire
  • patients who consented PSSQ
  • Internal validity Patients who consent are usually ‘good’ ones
  • External validity/generalizibility Jan- mac : major renovation work that disrupt OP work flow

Transcript

  • 1. Overview of Research Yvonne Lee Yin Leng, MPH Clinical Epidemiology Unit, CRC
  • 2. What is research?
    • A habit of questioning what you do , and empirical examination to find answers , with a view to make changes for more effective professional service
    • Example
      • How many patients come to IPR outpatients every day?
      • What are the most common conditions they come with?
      • What are the causes of these conditions?
      • Why only some people suffer from condition X while others do not?
      • Are all people with condition X coming to get treatment? If not why?
      • What happens to patients who get/did not get treatment?
      • For those who come for treatment, are they satisfied with our services?
      • How effective is the service? Compared with other centres?
      • How can our service be improved?
  • 3. How to answer the questions?
    • Research is just one of the many ways
    • Research study implies 3 things in your process;
      • Within a framework of a set of philosophies
      • Uses procedures, methods and techniques that have been tested for validity and reliability ; scientific
      • Designed to be unbiased and objective
  • 4.
    • Research is a structured inquiry that
    • utilises acceptable scientific methods to
    • solve problems and creates new
    • knowledge that is generally acceptable
    • (Grinell, 1993)
    Definition
  • 5.
        • Basic Biomedical research
        • Clinical Research
        • Epidemiological Research
        • Health Services Research
        • Methodological Research
    Type of research
  • 6. Basic Biomedical Research
    • Setting : Lab
    • Focus of study : Human anatomy, biology and physiology in relation to disease at organ/tissue  cellular/molecular/genetic level.
    • Goal : Explanatory  generate new knowledge that explains biological phenomena
  • 7. Epidemiological Research
    • Setting : Population / community (field epidemiology)
    • Focus of study :
      • a) Descriptive: prevalence / incidence study
      • b) Aetiology: causal / risk factors
      • c) Intervention: community intervention (CIT) for a prevention strategy, screening trial
    • Goals : Better control/prevention programmes
  • 8. Health services research
    • Settings : Health facilities
    • Focus of study : Identify health care needs, provisions, utilisation and effectivessness of health services.
    • a) Needs assessment study
      • b) Health services output: volume, case mix, quality of care
      • c) Intervention study: health services organisation trial
      • d) Evaluation study : eg health care cost study, costs effectiveness study, cost benefit study.
    • Goals : To support the decision making process at all levels  more effective health care delivery system.
  • 9. Methodological Research
    • Settings : Research centre
    • Focus of study : Research methodology (study design, sampling, variable measurement, data processing, stats methods)
    • Goals : Improve quality of research
  • 10. Clinical Research / Clinical Epidemiology
    • Settings : Hospital / clinics
    • Focus of study: Patient or disease oriented
    • Goals: Improve patients’ outcome
    • It provides data that clinicians can rely on in making decisions about patients
  • 11. Types of Clinical Research Patient comes to see a clinician Task: to make right diagnosis 1.Diagnostic studies 2.Taxonomic study 3. Validation studies Patient given Rx Task: to find most effective Rx ( good outcome) 1.Intervention studies / RCT 2. Outcomes studies Patient told prognosis Task: to predict a prognosis 1.Prognostic studies / prediction rules
  • 12. Summary of How Research Works (adapted from Hulley et al 2001) RESEARCH QUESTION TARG RESEARCH QUESTION TARG
    • Target population
    • Phenomena of interest
    Step1
  • 13. Summary of How Research Works (adapted from Hulley et al 2001) RESEARCH QUESTION TARG TARG STUDY PLAN TARG
    • Intended sample
    • Intended variable
    • & measurement
    design RESEARCH QUESTION TARG
    • Target population
    • Phenomena of interest
    Random & systematic Error Step1 Step2 Step3 Step4
  • 14. Summary of How Research Works (adapted from Hulley et al 2001) RESEARCH QUESTION TARG TARG TARG STUDY PLAN TARG
    • Intended sample
    • Intended variable
    ACTUAL STUDY TARG
    • Actual subjects
    • Actual measurement
    design RESEARCH QUESTION TARG
    • Target population
    • Phenomena of interest
    conduct Random & systematic Error Random & systematic Error design Random & systematic Error Step1 Step2 Step3 Step4 Step5
  • 15. Summary of How Research Works (adapted from Hulley et al 2001) RESEARCH QUESTION TARG TARG TARG STUDY PLAN TARG
    • Intended sample
    • Intended variable
    • & measurement
    ACTUAL STUDY TARG FINDINGS IN THE STUDY
    • Actual subjects
    • Actual data
    design RESEARCH QUESTION TARG
    • Target population
    • Phenomena of interest
    conduct Random & systematic Error Random & systematic Error Data analysis design conduct design Step1 Step3 Step4 Step5 Step6 Step2
  • 16. Summary of How Research Works (adapted from Hulley et al 2001)
    • Actual subjects
    • Actual data
    ACTUAL STUDY RESEARCH QUESTION TARG TARG TARG STUDY PLAN TARG TRUTH IN THE SAMPLE
    • Intended sample
    • Intended variable
    ACTUAL STUDY TARG FINDINGS IN THE STUDY
    • Actual subject
    • Actual measurement
    design RESEARCH QUESTION TARG
    • Target population
    • Phenomena of interest
    conduct Infer Random & systematic Error Random & systematic Error Data analysis RESEARCH QUESTION TARG TARG TARG STUDY PLAN TARG
    • Intended sample
    • Intended variable
    • & measurement
    TARG design RESEARCH QUESTION TARG
    • Target population
    • Phenomena of interest
    conduct Random & systematic Error Random & systematic Error design conduct design Step1 Step3 Step4 Step5 Step6 Step2
  • 17. Summary of How Research Works (adapted from Hulley et al 2001) ACTUAL STUDY ACTUAL STUDY RESEARCH QUESTION TARG TARG TARG TRUTH IN THE POPULATION STUDY PLAN TARG TRUTH IN THE SAMPLE
    • Intended sample
    • Intended variable
    ACTUAL STUDY TARG FINDINGS IN THE STUDY
    • Actual subject
    • Actual measurement
    design RESEARCH QUESTION TARG
    • Target population
    • Phenomena of interest
    conduct Infer Infer Random & systematic Error Random & systematic Error Data analysis
    • Actual subjects
    • Actual data
    RESEARCH QUESTION TARG TARG TARG STUDY PLAN TARG
    • Intended sample
    • Intended variable
    TARG
    • Actual subject
    • Actual measurement
    design RESEARCH QUESTION TARG
    • Target population
    • Phenomena of interest
    conduct Random & systematic Error Random & systematic Error RESEARCH QUESTION TARG TARG TARG STUDY PLAN TARG
    • Intended sample
    • Intended variable
    • & measurement
    TARG design RESEARCH QUESTION TARG
    • Target population
    • Phenomena of interest
    conduct Random & systematic Error Random & systematic Error design conduct design Step1 Step3 Step4 Step5 Step6 Step2 Step6