The document provides an overview of various healthcare research methods including experimental studies, qualitative studies, consensus methods, program evaluation, and screening/diagnostic tests. Experimental studies examine the effects of interventions by randomly assigning participants to intervention and control groups. Key aspects of experimental studies discussed are defining outcomes, selecting appropriate controls, blinding participants, randomization techniques, and analyzing results. Qualitative research aims to understand participant perspectives and experiences through techniques like interviews and focus groups. The document also outlines consensus methods such as the Delphi Method, program evaluation frameworks, and considerations for evaluating diagnostic tests.
"Hierarchies of Evidence" is an important but problematic concept for medical professionals to understand as it underpins their capacity to be effective practitioners and researchers.
"Hierarchies of Evidence" is an important but problematic concept for medical professionals to understand as it underpins their capacity to be effective practitioners and researchers.
This is a simple and general presentation about the health research which is prepared to present within staffs of Naulo Ghumti Nepal especially for EIHS staffs, objective if this presentation is to orient staffs about research.
Health research is the process of scientifically investigating a particular well-defined aspect of physical, mental, or social well-being of individuals.
How to scientifically conduct a clinical professional research trial? In the current era of Collaborate or parish, we need to keep this design in our mind.
Enjoy
@copyLeft
Bias, confounding and causality in p'coepidemiological researchsamthamby79
A brief description of three issues (Bias, Confounding and Causality) commonly encountered while performing pharmacoepidemiological research. A big THANK YOU to Mr. Strom and Mr. Kimmel.
This is a simple and general presentation about the health research which is prepared to present within staffs of Naulo Ghumti Nepal especially for EIHS staffs, objective if this presentation is to orient staffs about research.
Health research is the process of scientifically investigating a particular well-defined aspect of physical, mental, or social well-being of individuals.
How to scientifically conduct a clinical professional research trial? In the current era of Collaborate or parish, we need to keep this design in our mind.
Enjoy
@copyLeft
Bias, confounding and causality in p'coepidemiological researchsamthamby79
A brief description of three issues (Bias, Confounding and Causality) commonly encountered while performing pharmacoepidemiological research. A big THANK YOU to Mr. Strom and Mr. Kimmel.
Excelsior College PBH 321 Page 1 EXPERI MENTAL E.docxgitagrimston
Excelsior College PBH 321
Page 1
EXPERI MENTAL E PIDE MIOLOGICAL STUDIE S
Epidemiologic studies are either observational or experimental. Observational studies, including ecologic,
cross-sectional, cohort, and case-control designs, are considered “natural” experiments, but experimental
studies are considered true experiments. We will spend the next 2 modules discussing these designs.
Before we begin to discuss study designs, we need a brief introduction to a concept that we will spend more
time discussing in later modules -- bias. The definition of bias is:
“Deviation of results or inferences from the truth, or processes leading to such deviation. Any trend in the
collection, analysis, interpretation, publication, or review of data that can lead to conclusions that are
systematically different from the truth.” (Last, J.M., A Dictionary of Epidemiology, 4th ed.)
Epidemiologists are naturally concerned whether the results of an epidemiologic study are biased, since many
important public health decisions are often drawn from epidemiologic research. The severity of the bias, that
is - how much it influences or distorts the results, is related to the study design as well as how information is
analyzed.
Experimental Studies
The defining feature of experimental studies is that the investigator assigns exposure to the study subjects.
Experimental studies most closely resemble controlled laboratory experiments and serve as models for the
conduct of observational studies, thus they are the “gold standard” of epidemiologic research. Experimental
studies have high validity (i.e., less bias), and can identify even very small effects. The most well known type of
experimental study is a randomized trial (sometimes referred to as a randomized controlled trial), where the
investigator randomly assigns exposure to the study subjects. In this type of study, the only expected
difference between the experimental and control groups is the outcome variable being studied.
Experimental designs like the randomized trial can assess both preventive interventions, where a prophylactic
agent is given to healthy or high-risk individual to prevent disease, or can assess effects of therapeutic
treatment, such as those given to diseased individuals to reduce their risk of disease recurrence, or to improve
their survival or quality of life.
Preventive intervention: Does tamoxifen lower the incidence of breast cancer in women with high risk profile
compared to high risk women not given tamoxifen?
Therapeutic intervention: Do combinations of two or three antiretroviral drugs prolong survival of AIDS
patients as well as regimens of single drugs?
The investigator can assign exposures (or allocate interventions) to either individuals or to an entire
community.
Individual-level assignment: Do women with stage I breast cancer given a lumpectomy alone survive as long
without recurrence of disease as women given a lumpec ...
From History to Application Procedure OF CLINICAL TRIALS IN INDIA. PHASES 0,1,2,3,4 & 5.IMPORTANCE, advantages, guidelines global and India. Types, Design & blinding technique.
The randomised controlled trial (RCT) .pptxPRITIBISANE
Randomized controlled trials (RCT) are prospective studies that measure the effectiveness of a new intervention or treatment.
Randomization reduces bias and provides a rigorous tool to examine cause-effect relationships between an intervention and outcome
HEALTHCARE RESEARCH METHODS: Secondary and tertiary StudiesDr. Khaled OUANES
Secondary analyses are based on the use of pre-existing data sets and usually the researcher conducting the statistical analysis has not had any contact with the participants whose data are being examined.
A systematic review is, on the other hand, the thorough compilation and summary of all publications relevant to a particular research topic.
HEALTHCARE RESEARCH METHODS: More on reviewing the literatureDr. Khaled OUANES
Once you have a good idea about the existing literature in general (Gather as many articles, reports and books as possible), You can start digging into individual articles.
The Process of Health Research and literature reviewsDr. Khaled OUANES
Identifying a study topic is often the most challengingpart of a research project.Each of the possible study topics has its own set of virtues and shortcomings.
Any student in a high level institution will be usually required to write a variety of dissertations, papers and essays throughout the whole period of their studies.
These writing tasks and assignments will cover a myriad of goals, objectives and purposes.
Organizational communications can be defined as the process by which information is exchanged and understood by two or more people, usually with the intent to motivate or influence behavior.
In our personal lives, at work, within teams, and in management in general, a continuing stream of information, data, problems, and opportunities drive and nurture decision making.
Human resources can be defined as the set of individuals who make up the workforce of an organization or even bigger entities (Sectors, economies…)
One major way to evaluate the effectiveness of HR management is the productivity of the organization. The overall goal of a HR department should be to develop the human capital of the firm.
HCM114 Change, motivation and innovation in HealthcareDr. Khaled OUANES
People often say that motivation doesn’t last. That’s why we have to reinvigorate it everyday. Being and working in the right setting and in a fit culture will really help.
INTRODUCTION TO ORGANIZATIONAL BEHAVIOR
The Study of human behavior in organizations.
An interdisciplinary field devoted to understanding individual & group behavior, interpersonal processes, & organizations dynamics.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
3. An experimental study assigns participants to
intervention and control groups in order to
examine whether an intervention causes an
intended outcome.
Because the researcher assigns participants to
receive a particular exposure, the exact
timing, dose, duration, and frequency of the
exposure are known.
5. Randomized Controlled Trials (RCTs)
In a randomized controlled trial (RCT):
Some participants are randomly assigned to an
active intervention group
The remaining participants are assigned to a
control group
All participants from both groups are followed
forward in time to see who has a favorable
outcome and who does not
6. Describing the Intervention
The research plan should carefully define:
What the intervention will be
Where and how participants will receive the
intervention
When, how often, and for what duration
participants will receive the intervention
Eligibility and aptness criteria for participants
7. Defining Outcomes
Most experimental studies are superiority trials
that aim to demonstrate that a new intervention
is “better” than some type of control.
Because the term “better” can be defined in so
many ways, the researcher must beforehand
and carefully define what constitutes a
favorable outcome for the experiment.
10. Selecting Controls
Experimental studies usually assign some
participants to the active intervention and the
remainder to a control group.
SO WHAT TYPES OF CONTROLS CAN
WE HAVE?
11. 1. The most typical control is a placebo, an
inactive comparison that is similar to the
therapy being tested
2. Sometimes the new therapy is compared to
some existing “industry standard of care” or
other therapy
3. Sometimes varying doses and durations of a
therapy may be compared to one another
Selecting Controls
14. Hawthorne bias
Hawthorne effect: (observer effect) is a type of
reactivity in which participants in a study may
change their behavior for the better simply
because they know they are being observed
This may interfere with the accurate
measurement of the impact of the new
intervention.
15. Blinding
Blinding or masking:
Participants in an experimental study do not
know whether they are in the active intervention
group or the control group.
Blinding minimizes information bias
16. Blinding
There are 2 main cases:
In a single-blind study, participants are unaware of
their exposure status
In a double-blind study, neither the participants nor
the persons assessing the participants’ health status
know which participants are in the active and control
groups.
17. Randomization
A variety of approaches can be used to
randomly allocate participants to an active
intervention group or a control group:
Simple randomization
Block randomization
Stratified randomization
18. Examples of Types of
Randomization
Strata:
Homogeneous
subgroups of
members in
the population
19. Ethical Considerations
Experimental studies involve a particularly high
level of ethical risk because the researcher
assigns participants to exposures that the
participants do not choose and may have
been unlikely to encounter in normal life had
they not volunteered to participate in a
research project.
20. Ethical Principles
Clinical Equipoise or equipoise principal:
It provides the ethical basis for medical research
that involves assigning patients to different
treatments of a clinical trial. The term was first used
by Benjamin Freedman in 1987. It states that
experimental research should be conducted only
when there is genuine uncertainty about which
treatment will work better
21. Ethical Principles
Distributive justice: infers that the source
population must be an appropriate and non-
exploitative one
Beneficence (doing good) and non-maleficence
(do not harm): researchers must balance the
likely benefits and risks of the study. Otherwise the
study should not be conducted.
22. Respect for persons:
Participants must volunteer for a study without being
unduly influenced by the prospect of being
compensated for their participation
Participants must be able to understand what it
means to be a research subject, including the
possibility of being assigned to a control group
instead of the new intervention
Ethical Principles
24. Analysis
Experimental studies use many of the same measures of
association that cohort studies do:
Relative rates (RRs)
Attributable risks (ARs, AR%s)
Measures of survival
Experimental studies use these measures to examine
the impact of an assigned exposure on the likelihood of
having either a favorable or unfavorable outcome.
25. Analysis: Efficacy
Efficacy: the proportion of individuals in the control
group who experience an unfavorable outcome
who could have been expected to have a
favorable outcome had they been in the active
group instead of control.
A high efficacy is an indicator that an intervention
is successful.
26. Analysis: NNT
Number needed to treat (NNT): the expected number of
people who would have to receive a treatment to
prevent an unfavorable outcome in one person (or,
alternately stated, to achieve a favorable outcome in
one person)
A small NNT indicates a more effective intervention.
27. If a drug is intended to prevent stroke and has an NNT
of 5, then 5 people have to take the drug for one year
(or some other chosen time span) to prevent one of
the 5 from having a stroke.
If a drug has an NNT of 100, it means that 100 people
have to take the drug to prevent one of the 100 from
having a stroke.
Analysis: NNT
28. Stratification of patients for efficacy can
substantially reduce the number
needed to treat for benefit.
Matthews, P. M. et al (2013)
29. In the example depicted in the previous slide, 22% of
patients respond to a given treatment, so
approximately 5 patients need to be treated to benefit
one patient (NNT=5). If the population is stratified to
enrich the treated population with responders
(identified through testing), the number needed to treat
for benefit will decrease. In this example, a
stratification approach with 90% sensitivity and
specificity is assumed.
31. Analytic Frameworks
Treatment-received approach: limit analysis to
the participants who were fully compliant with
their assigned intervention
Treatment-assigned approach (intention-to-
treat approach): includes all participants even
if they were not fully compliant with their
assigned intervention
34. Screening & Diagnostic Tests
The goal of some studies is to compare two
tests that are supposed to measure the same
thing, such as comparing the results of an
antibody test for cancer to biopsy results
35. Sensitivity = Of those who have the disease,
what % test positive?
Specificity = Of those who do not have the
disease, what % test negative?
Screening & Diagnostic Tests
36. Positive predictive value (PPV) = Of those
who test positive, what % actually have the
disease?
Negative predictive value (NPV) = Of those
who test negative, what % actually do not
have the disease?
Screening & Diagnostic Tests
38. Tests of Agreement
Tests of inter-observer agreement (concordance) can
be used to determine the extent of agreement between
two assessors who are evaluating the same study
participants
Example: a measurement known as the kappa statistic can
indicate whether two radiologists examining the same set of X-rays
reach the same conclusion about the presence or absence of a
fracture more or less often than can be expected by chance
40. Qualitative Study Methods
A qualitative study looks for the themes and
meanings that emerge from the observation
and evaluation of a situation or context.
Researchers have intense contact with a
selected group of informants.
41. Examples of Approaches
Phenomenology: seeks to understand how participants
understand, interpret, and find meaning in their own
unique life experiences and feelings
Grounded theory: an inductive reasoning process that
uses observations to develop general theories that
explain human behavior
Ethnography: aims to develop an insider’s view (an emic
perspective) of how members of a particular Ethnic or
cultural group see their world
42. Examples of Techniques
In-depth and semi-structured interviews of individuals
use open-ended questions to explore viewpoints. The
interviewer is allowed to probe for more details about
any response in order to gain fuller understanding of the
participant’s experiences and perspectives.
Interviews are often supplemented by other methods,
such as participant diaries or journals.
43. Focus groups of about 4 to 12 people are
moderated discussions led by a facilitator
from the research team. The facilitator
encourages participants to interact with
one another and to clarify their individual
and shared perspectives.
Examples of Techniques
44. Examples of Analytic Techniques
The analysis of qualitative data usually involves coding
and classifying observations and deriving major and
minor themes from the groups of observations.
Reports of the findings of qualitative studies often
incorporate quotations that express participants’
perspectives and experiences in their own words.
45. Consensus Methods
The goal of some studies is to identify areas of
consensus and areas of contention among
individuals who are experts on a particular
topic and/or a particular community or
organization.
46. Delphi Method
The Delphi method is a structured decision-making and
forecasting process in which participants engage in several
rounds of:
Completing individual questionnaires
A facilitator summarizing and sharing the responses
Panelists reconsidering their perspectives after reflecting
on the opinions expressed by others
The goal is for each iteration to move the panel of experts
closer to agreement.
48. Program Evaluation
Program evaluation includes a variety of approaches
for provide feedback about what is working well and
what can and should be improved
The evaluation approach must match the goals of the
assessment
After gathering evidence from a variety of sources,
practical suggestions are made based on the
conclusions of the assessment
49. Evidence is reviewed and categorized using a framework like
SWOT:
Strengths (internal organizational strengths)
Weaknesses (internal organizational limitations)
Opportunities (external strengths)
Threats (external limitations, which might be political, economic,
sociocultural, technological, environmental, or legal)
Program Evaluation
51. A similar process can be used as a
component of other forms of evaluative
research, such as:
Needs assessment.
Cost-effectiveness analysis
Health services research
Program Evaluation
52. PHC215
By Dr. Khaled Ouanes Ph.D.
E-mail: k.ouanes@seu.edu.sa
Twitter: @khaled_ouanes
HEALTHCARE RESEARCH METHODS
Based on the textbook of introduction to health research methods – K.H. Jacobsen