Research Methods Midterm

WHO definition of health

a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity

research

the process of systematically and carefully investigating a subject in order to discover new insights about the world

health research

investigation of health and disease or any of the factors that contribute to the presence or absence of physical, mental, and social health among individuals, families, communities, nations or the world population

Epidemiology

The study of the distribution and determinants of health-related states in specific populations, and the application of this study to control of health problems

Biostatistics

application of statistics to biological and medical problems. This is one of the basic sciences of public health, applied in the analysis of vital and health statistics and in the use of statistical tests for associations, correlation, significance levels, etc.

Determinants of health

investigation of health and disease or any of the factors that contribute to the presence or absence of physical, mental, and social health among individuals, families, communities, nations or the world population

clinical reserach

evaluates the best ways to prevent, diagnose, and treat adverse health issues that adversely affect individuals and families

population health research

focuses on the health outcomes and the determinants of health in groups of humans

biological research

looks at changes at human cellular level that can be related to the health outcomes

5 step research process

1. Identify a study question
2. Select a general study approach
3. Design the study and collect data - measure variables
4. Analyze data - measures of occurrence/associations, causation, bias confounding
5. Write and share a report about the findings - publish, present

brainstorming

process of generating long lists of spontaneous ideas about possible research questions

aspects of making research question

interest, aptitude's, applications, mentors

interest

what are my interests? what diseases have effected me or family?

Aptitudes

what knowledge/skills do i already have? What methods am i prepared to apply?

applications

what studies would help improve health related practices or policies?

Mentors

what are areas of expertise of my profs, teachers, other mentors? What data would be available to me through my mentors?

concept mapping

visual listing of ideas and grouping them to reveal relationships

question on Exposure, Disease, Population (EDP) structure

"Is [exposure] related to [disease/outcome] in [population]?"

exposure

personal characteristic (socioeconomic status), behaviour (smoking), environmental encounter (pollution), or intervention (treatment) that might change the likelihood of developing a health condition

disease/outcome

observed event such as the presence of disease in a participant in an observational study or the measured endpoint in an experimental study

Population

a group of individuals, communities, or organizations with identifiable similar characteristics

Population

A group of individuals, communities, or organizations with identifiable similar characteristics

Standard of Health Research

PICOT

what does PICOT stand for

P - patient, population group, and problem being studied
I - Intervention that will be tested?
C - control group, what will intervention be compared to
O - outcome of interest
T - Timeframe for follow-up?

What makes a good research question?

real question, testable, generalizable, purposeful

4 key questions to refining study questions

1. What is the one well-defined research question that the study will answer?
2. What specific aims, objectives, or hypotheses will enable the key question to be answered?
3. Would a conceptual framework be helpful for guiding the design, analysis, and interpretation of the study and its results?
4. Is the proposed study feasible? Is there a high likelihood that the research team will be able to answer the study's main research question?

study goal

single overarching objective of a research project or the main question that a research project seeks to answer

specific objectives

Carefully described action that will help the researcher make progress toward achieving the big-picture goal
- Most studies in the health sciences have two to four specific aims, with three the most typical number

sequential objectives

chronological list of actions that will achieve the main goal

independent objectives

related but independent objectives. When one objective is not achieved, it will not prevent successfully completion of the other objectives

SMART acronym

Specific, Measurable, Attainable, Realistic, Timely

theoretical frameworks

a set of established models in the published literature that can inform the components and flows of the conceptual framework for a new research study

why use models in health research?

To organize our thoughts
To explore determinant/health relationships in a systematic manner
As a guide for analysis
To identify 'modifiable' factors for intervention

Lalondes Model - A New Perspective on the Health of Canadians

considered to be first modern government doc in Western context to propose the health field look beyond the biomedical health care system.

Proposed health field = human biology + environment + lifestyle + health care organization

Eco-Social Model

consists of the microsystems, mesosystems, macrosystems, exosystems, chronosystems

conceptual model

a researcher sketches using boxes and arrows to illustrate the various relationships that will be evaluated during a study

translational research

bridges basic research and clinical research by applying scientific discoveries to the improvements of clinical outcomes
--> the aim of this research is to move research from the lab to clinical care settings - apply to real life

Public Health

actions taken to promote health and prevent illnesses, injuries, and early deaths at the population level

MeSH (Medical Subject Headings)

vocab thesaurus that can be used for searches of mediline and other health science databases

risk factor

an exposure that increases individual's likelihood of experiencing a particular disease

protective factors

exposure that reduces an individual's likelihood of subsequently experiencing a disease or outcome

nonmodifiable risk factors

risk factor for a disease that cannot be changed through health interventions

3 levels of preventive action

primary prevention, secondary prevention, tertiary prevention

primary prevention

encompasses health behaviours and other protective actions that help keep an adverse health event from occurring in people who do not already have the condition
Ex; nutritious diet, exercise, sleep, vaccinations

secondary prevention

detection of health problems in asymptomatic individuals at an early stage when conditions have not yet caused significant damage to the body - can be treated more easily
Ex; cancer screening, blood pressure checks, audiovisual checks

Teriatary structure

interventions that reduce impairment, minimize pain and suffering, and prevent death in people with symptomatic health problems
Ex; medications, surgery, palliative care

Comorbidity

2 or more adverse health conditions at the same time

EDPs

exposures, diseases, and populations

Evidence based medicine (EBM)

uses results of rigorous research studies to optimize clinical decision making

Testability

ability of a research question to be answered using experiments or other types of measurements
--> good research question must be testable

purposiveness

states that research projects should be designed to answer one well-defined research question

Hypothesis

informed assumption about the likely outcome of a well-designed investigation that can be tested using scientific methods

conceptual framework

researcher sketches using boxed and arrows to illustrate the various relationships that will be evaluated

Health belief model

considers health behavior change to be a function of perceived susceptibility to an adverse health outcome

Feasibility study

an evaluation of the likelihood that a task can be completed with the time, money, tech, and other resources that are available

how is data in health research usually collected?

via sampling

target population

broad population to which the results of a study should be applicable

source population

subset of individuals from the target population from which the potential study participants will be sampled

sample population

individuals from a source population who are invited to participate in the research project

study population

compromises the eligible members of the sample population who consent to participate in the study an complete required study activities

probability sampling

Involves using selection techniques wherein the probability of selecting each sampling unit is known

simple random sampling

participants randomly selected, each person has an equal chance of being selected

systematic sampling

after a random start point, every nth person is selected

stratified sampling

Random samples from distinct groups
- Geography (urban, rural, suburban)
- Sex (male, female, other)

cluster sampling

- Natural clusters (schools, neighbourhoods) rather than individual units are selected
- Observation are made on all units within a cluster
- Cluster sampling of schools
- All eligible children within each school included

multistage sampling

- Primary sampling units are selected (e.g. municipalities)
- Secondary units selected within primary units (e.g. individuals)
- May have more levels
- Secondary units: city blocks
- Tertiary units: individuals

convience sample

Selection from a nonprobability-based source population due to ease of access to those individuals, schools, workplaces, organizations, or communities

purposive sampling

Recruitment of the participants for a qualitative study based on the special insights they can provide

selection bias

members of the study population are not representative of the source population from which they are drawn --> when healthier or educated people are more likely to volunteer for research

types of selection bias

exclusion, healthy worker, berksons

Berkson's bias

can occur when cases and controls for a study are recruited from hospitals and therefore are more likely than the general population to have comorbid conditions

Healthy Worker Bias

can occur when participants are recruited from term-72occupational populations and therefore are systematically healthier than the general population

Exculsion Bias

occurs when different eligibility criteria are applied to cases and controls, such as when controls with health conditions related to an exposure are excluded but cases with those comorbidities are not excluded

vulnerable populations

might have limited ability to make an autonomous decision about volunteering to participate in a research study
ex; young children, Some individuals with serious health issues, People in prison and some other socially marginalized populations

Type 1 error (false positive)

occurs when a study population yields a statistically-significant test result even though a significant difference or association does not actually exist in the source population

Type 2 error (false negative)

occurs when a statistical test of data from research finds no significant result even though a significant difference or association actually exists in the source population

interview

process of verbally asking a participant questions and recording that person's responses

self-administered survey

questionnaire form that participants complete by themselves, using either a paper-and-pencil version or online

Semi-structured interview

interviewer starts with a list of open-ended questions that will be asked of each participant, but these questions or lists of topics are merely starting points for eliciting responses from participants

probing

interviewing technique that prompts an interviewee to provide a more complete or specific response

Interview Pros and Cons

pros - can train interviewers to ensure the accuracy and completeness of each questionnaire
cons - may require major time commitments, expensive

questionnaire pros and cons

Pros - cost- and time-efficient
Possibly of approaching a large number of participants
The best way to get honest answers to sensitive questions
Cons - Problematic for low literacy populations, and those who have limited Internet access or be unfamiliar with computers

interviewer bias

interviewers systematically question cases and controls or exposed and unexposed members of a study population differently, such as probing only individuals they believe to have the disease or exposure of interest for more information

uniformity

easiest to accomplish when all interviewers are provided with the tools they need to follow a standardized set of procedures

close-ended questions

allow a limited number of possible responses
- Date and time questions
- Numeric questions
- Categorical

open-ended questions

allow an unlimited number of possible responses

Practical Considerations

order of questions, getting the right answer, data recording methods, layout and formatting, back translation, pilot testing

Order of Questions

better to start with easy or at least general questions before moving to more difficult or sensitive questions

Getting the correct answer

mix up questions to prevent habituation and get accurate answers

Habituation

error that occurs when participants become so accustomed to giving a particular response (like "agree... agree... agree...") that they continue to reply with the same response even when that does not match their true perspectives

data recording method options

1. Record the responses on paper and to enter or scan them into a computer later
2. Have interviewers or participants enter responses directly into a database -->Eliminates the need for later data entry, Some populations are uncomfortable with computer technology

pilot testing

A small-scale preliminary study conducted to evaluate the feasibility of a full-scale research project

Key informants

individuals selected to participate in a qualitative study because they have the expertise relevant to the study question

Confidence interval

statistical estimate of the range of likely values of a parameter in a source population based on the value of that statistic in a study population
--> how 'good' an estimate is
--> Narrow CI indicates more certainty about the value of the statistic than a wide CI

Power

ability of a test to detect significant difference in a population when differences do exist
- the power of statistical tests increases when a large number of participants are included

Exposure measurement

available dose - Cumulative vs. current
administered dose - The amount that comes in contact
absorbed dose (uptake) - The amount that enters the body
Active dose (biologically effective) - That actually affects the specific target organ

ratio

Relationship between 2 numbers
Numerator NOT necessarily INCLUDED in the denominator
ex; (binary) sex ratio

proportion

Relationship between 2 numbers
Numerator NECESSARILY INCLUDED in the denominator
Proportion always ranges between 0 and 1

odd

the probability of an event occurring relative to it not occurring

rate

speed of occurence overtime
numerator = # of events observed for a given time
denominator = population where events occur (population at risk)