RESEARCH In OMFS

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A GIST OF HOW TO CONDUCT A RESEARCH STUDY AND THE RECENT RESEARCH ADVANCES IN THE FIELD OF ORAL AND MAXILLOFACIAL SURGERY

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  • How do we determine our population of interest? Administrators can tell us We notice anecdotally or through qualitative research that a particular subgroup of students is experiencing higher risk We decide to do everyone and go from there 3 factors that influence sample representativeness Sampling procedure Sample size Participation (response) When might you sample the entire population? When your population is very small When you have extensive resources When you don’t expect a very high response
  • Picture of sampling breakdown
  • Two general approaches to sampling are used in social science research. With probability sampling , all elements (e.g., persons, households) in the population have some opportunity of being included in the sample, and the mathematical probability that any one of them will be selected can be calculated. With nonprobability sampling , in contrast, population elements are selected on the basis of their availability (e.g., because they volunteered) or because of the researcher's personal judgment that they are representative. The consequence is that an unknown portion of the population is excluded (e.g., those who did not volunteer). One of the most common types of nonprobability sample is called a convenience sample – not because such samples are necessarily easy to recruit, but because the researcher uses whatever individuals are available rather than selecting from the entire population. Because some members of the population have no chance of being sampled, the extent to which a convenience sample – regardless of its size – actually represents the entire population cannot be known
  • RESEARCH In OMFS

    1. 1. RESEARCH IN OMFS BY VINEETHA.K CRI
    2. 2. WHAT IS RESEARCH? RESEARCH- “is the continual search for truth using the scientific method” ORAL HEALTH RESEARCH – “refers to laboratory, clinical and field investigations that lead to improvement in the control of oral diseases and health care delivery”
    3. 3. WHY DO CLINICAL RESEARCH? • To promote the oral health of the public • To contribute new knowledge or reevaluate current knowledge. • To improve techniques and practices of identifying , preventing and treating oral diseases. • To develop and test theories related to oral health care. • To solve problems in advancement , decision making and change in oral health delivery.
    4. 4. 542-03-#4 CLASSIFICATION OF RESEARCH STUDIES: OBSERVATIONAL STUDIES:OBSERVATIONAL STUDIES: • Groups are studied & contrasts made between groups ANALYTIC STUDIES:ANALYTIC STUDIES: • Study the impact of a certain therapy CLINICAL TRIAL:CLINICAL TRIAL: • Considered the “true” experimental study • “Gold Standard” of clinical research
    5. 5. THE DIFFERENT STUDY DESIGNS • Case-control • Cohort • Case Reports • Survey Research: Questionnaires Polls Surveys • Meta Analyses • Randomized Clinical Trial
    6. 6. BASIC RESEARCH TERMINOLOGY • Case Control Study:Case Control Study: Persons w/ disease & those w/out are compared • Cohort Study:Cohort Study: Persons w/ and/or w/out disease are followed over time • Cross-sectional Study:Cross-sectional Study: Presence or absence of exposure to possible risk factor measured at one point in time.
    7. 7. • LoLongitudinal study :ngitudinal study : study that provides data about events or changes during a period of time. • Prevalence:Prevalence: The # of new cases and existing cases during specified time period. • Incidence:Incidence: The # of NEW cases per unit of a population at risk for disease occurring during stated time period.
    8. 8. RESEARCH DESIGN Formulating a hypothesis Review of the literature Methods and materials Statistical evaluation
    9. 9. GETTING STARTED • FORMULATION AND SET FRAMEWORK OF RESEARCH PROBLEM • “A RESEARCHABLE PROBLEM IS A STATEMENT OR QUESTION THAT POSES AN UNKNOWN RELATIONSHIP BETWEEN VARIABLES AND SERVES TO FOCUS THE ENTIRE INVESTIGATION”
    10. 10. HYPOTHESIS • HYPOTHESIS is defined as “a tentative prediction or explanation of the relationship between two or more variables.” • Hypothesis is the foundation on top of which you build your thesis
    11. 11. REVIEW OF LITERATURE The literature that is relevant to the problem must be concisely reviewed It can be -Indices -Computer based literature searches - Bibliographies
    12. 12. ELIGIBILITY CRITERIA Eligibility criteria are guidelines that describe characteristics that must be minimally shared by all participants. The criteria differ from study to study. Criteria include: • Age • Gender • Medical history • Current health status • Lab values
    13. 13. INCLUSION/EXCLUSION CRITERIA •Factors that allow someone to participate in a clinical trial are "INCLUSION CRITERIA“ • Factors that exclude or do not allow participation in a clinical trial are "EXCLUSION CRITERIA“
    14. 14. SAMPLING • What is your population of interest? – To whom do you want to generalize your results? SAMPLING “Is the process or technique of selecting a sample of appropriate Characteristics and adequate size “
    15. 15. n
    16. 16. TYPES OF SAMPLES • PROBABILITY (RANDOM) SAMPLES  – Simple random sample – Systematic random sample – Stratified random sample – Cluster sample • NON-PROBABILITY SAMPLES – Convenience sample – Purposive sample – Quota
    17. 17. SAMPLE SIZE •Bigger the sample higher will be the precision of the estimates of the sample . •An optimum size of the sample is to be considered.
    18. 18. INFORMED CONSENT Informed consent is the process of providing potential participants with important facts about a clinical trial before they decide to participate.
    19. 19. BIAS SELECTION BIAS- occurs when a group studied does not reflect the same distribution of characteristics like age, sex, occupation , race etc. as occuring in general population. INFORMATION BIAS-occurs when there is an error in the classification of individuals with respect to the outcome variable. This may result from measurement errors, imprecise measurements and misdiagnosis of cases. CONFOUNDING BIAS – confounding occurs when other factors that are associated with the outcome and exposure variables do not have the same distribution in the exposed and unexposed groups.
    20. 20. BLINDING A)Single blind trial : the trial is so planned that the participant is not aware whether he belongs to the study group or control group. B)Double blind trail: The trial is so planned that neither the investigator nor the participant is aware of the group allocation and the treatment received. c)Triple blind trial : The participant , the investigator and the person analyzing the data are all blind.
    21. 21. EPIDEMIOLOGY VS RCT • Epidemiology allows the study of the real world and the development of hypothesis regarding disease states • Randomized, controlled trials allow the rigorous testing of hypothesis in a well characterized manner that is less real world in nature
    22. 22. CASE CONTROL STUDY • The same problem could also be studied in a case-control study. A case-control study begins with the selection of cases (people with a disease) and controls (people without the disease). The controls should represent people who would have been study cases if they had developed the disease (population at risk).
    23. 23. COHORT STUDY • Cohort studies begin with a group of people (a cohort) free of disease. The people in the cohort are grouped by whether or not they are exposed to a potential cause of disease. The whole cohort is followed over time to see if the development of new cases of the disease (or other outcome) differs between the groups with and without exposure.
    24. 24. RANDOMIZED CONTROL CLINICAL TRIAL • Patients assigned at random to either treatment(s) or control • Considered to be “Gold Standard”
    25. 25. ETHICS OF CLINICAL TRIALS: PROTECTION OF PARTICIPANTS 3 ethical principles guide clinical research: • Respect for Persons:Respect for Persons: Treatment of person as autonomous • Beneficence:Beneficence: Issue re: potential conflict between good of society vs. individual • Justice:Justice: Treatment of all fairly & all equally share benefits & risks
    26. 26. DATA • Data are the facts you measure • They should be carefully recorded in an unbiased manner • They should be measured in a manner that minimizes random variation • They should be derived from the operational definitions you have developed
    27. 27. COLLECTION OF DATA Qualitative data: when the data is collected on the basis of attributes or qualities like age , sex etc., it is called qualitative data. Quantitative data: When the data is collected through measurement example – LA drug dose , SOURCE OF DATA Primary source – Data obtained by the researcher himself. This is first hand information. Secondary source – The data already recorded is utilized to serve the purpose of the objective of the study. Eg . The records of the OPD of dental clinics
    28. 28. METHODS OF DATA COLLECTION INTERVIEWS QUESTIONNAIRES ORAL EXAMINATION
    29. 29. ANALYSIS AND INTERPRETATION •Analysis and interpretation is done using biostatistics •BiostatisticsBiostatistics- is that branch of statistics concerned with mathematical facts and data related to biological events.
    30. 30. RELIABILITY AND VALIDITY • RELIABILITY – The extent to which a test is repeatable and yields consistent scores – Affected by random error/bias • VALIDITY – The extent to which a test measures what it is supposed to measure – A subjective judgment made on the basis of experience and empirical indicators – Affected by systematic error/bias
    31. 31. WRITING IT UP • If you don’t write it, then it didn’t happen • Order of writing: – Title – Abstract – Introduction – Aims and objectives – Methods – Results – Discussion – Conclusion – References
    32. 32. SENDING IT IN • When writing the paper, have the journal you will submit to in mind • Pick journals that will match your paper’s topic and the quality and importance of your work.
    33. 33. PRESENTING THE RESEARCH • Scientific writing – Original / full research reports – Short communications – Case stories – Systematic reviews / meta-analysis – Books or book chapters – Academic thesis – Conference abstracts
    34. 34. ORAL PRESENTATIONS – lectures – Seminars – Courses PUBLIC RELATIONS – Media - press release – Internet
    35. 35. EVIDENCEEVIDENCE BBASEDASED DDENTISTRYENTISTRY Evidence-based dentistry is the practice ofEvidence-based dentistry is the practice of dentistry that integrates the bestdentistry that integrates the best available evidence with clinicalavailable evidence with clinical experience and patient preference inexperience and patient preference in making clinical decisions.making clinical decisions.
    36. 36. THE STAGES IN EVIDENCE-BASED PRACTICETHE STAGES IN EVIDENCE-BASED PRACTICE Identify Clinical ProblemIdentify Clinical Problem Produce a Focused Clinical QuestionProduce a Focused Clinical Question Search for EvidenceSearch for Evidence Evaluate the EvidenceEvaluate the Evidence Incorporate Evidence into PracticeIncorporate Evidence into Practice Evaluate the Impact on PracticeEvaluate the Impact on Practice
    37. 37. META-ANALYSISMETA-ANALYSIS • Meta-analysisMeta-analysis is a review that uses quantitative methods to combine the statistical measures from two or more studies and generates a weighted average of the effect of an intervention, degree of association between risk factor and a disease, or accuracy of a diagnostic test.
    38. 38. WeakerWeaker StrongerStronger
    39. 39. RESEARCH ADVANCES IN OMFS LABORATORY RESEARCH • Bone tissue engineering with human serum • Gene Expression Profiling of the “Field of Injury” in Head and Neck Cancer • CASE CONTROL STUDIES • Open vs. closed treatment of bilateral mandibular condyle and anterior mandibular fractures: • CLINICAL TRIALS Temporomandibular Joint - Clinical Trials Orthognathic Surgery – Relapse Implants
    40. 40. TEMPOROMANDIBULAR JOINT – ANIMAL MODEL - SEVERAL MODELS OF INTERNAL DERRANGEMENT , OSTEOARTHRITIS AND ANKYLOSIS HAVE BEEN DEVELOPED. -THESE MODELS ARE USED TO UNDERSTAND PATHOPHYSIOLOGY OF CONDITIONS. -TO EVALUATION VARIOUS MEANS OF SURGICAL RECONSTUCTION
    41. 41. TEMPOROMANDIBULAR JOINT - CLINICAL TRIALS A NUMBER OF PROSPECTIVE TRIALS OF VARIOUS TREATMENT METHODS ARE IN PROGRESS. THESE INCLUDE -ARTHROSCOPY -TEMPORALIS MUSCLE RECONSTRUCTION -OPEN REDUCTION OF FRACTURE DISLOCATIONS -TMJ IMPLANTS.
    42. 42. IMPLANTS -TRANSMANDIBULAR IMPLANT FOLLOW-UPS -PROSPECTIVE TRIALS OF HYDROXYAPATITE COATED TITANIUM IMPLANTS -EVALUATION OF EXTRA ORAL IMPLANTS
    43. 43. CLEFT LIP AND CLEFT PALATE • MAXILLARY ADVANCEMENT WITH CONVENTIONAL ORTHOGNATHIC SURGERY • STUDY OF OPERATIVE OR ANATOMIC FACTORS AFFECTING DENTAL ARCH DEVELOPMENT.
    44. 44. ORAL CANCER • UNDERSTANDING MOLECULAR BIOLOGY OF ORAL CANCINOGENESIS. • CREATION OF A TUMOUR PROGRESSION MODEL • ASSESSMENT OF QUALITY OF LIFE IN PATIENTS WHO HAVE UNDERGONE SURGERY FOR ORAL CANCER.
    45. 45. JOURNALS OF OMFS
    46. 46. “To do successful research, you don't need to know everything, you just need to know of one thing that isn't known.”

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