nature and uses of research

components of a research report

- background

- results

- methods

- conclusions

background

origins of the research question and context for the study

results

presentation of the data and data analysis

methods

participant selection, intervention, instrumentation, outcome measures, etc

conclusions

how the authors believe the finding should be understood and applied to practice

more potentially applicable research artices

reference farming and citations of the article in other works

discerning credibility

- peer review

- journal quality

- author reputation

- funding source

peer review

journal editorial board and review process

journal quality

reputation and impact factor (journal citation reports)

author reputation

credentials of the primary 1st author

funding source

NIH, major private philanthropic org (grant process)

reasons for concern: study lacks clarity in -

- specific variables being studied

- rationale for conducting the study

- treatment or intervention if there is one

- number and characteristics of the subjects

- interactions of the investigator with the subjects

- the setting for the study, particularly for the collection of data

- methods used to collect data

- analysis used to determine the results

reasons for concerns questions to ask

- is the sampling appropriate

- can the study be replicated

- are there conflicts of interest

- are there signs of carelessness

a dozen questions to ask when reading research

clarifying the problem

identifying the problem through clinical experience, clinical theory, professional literature

research rationale is through

review of literature, theoretical framework, purpose

research rationale: review of literature (what questions to be asked?)

- is there a systematic review or meta-analysis available?

- is the target population represented?

research rationale: theoretical framework (what questions to be asked?)

- what has been established in previous studies?

- specific to patient population? pathology?

what are the types of research?

quantitative, empirical research, qualitative

deductive reasoning

acceptance of a general premise upon which inferences can be drawn for specific cases, testable hypothesis

inductive reasoning:

begins with experiences, data gathered informs generalizations, conceptual frameworks created from emerging patterns

PICO question

P: population or problem

I: innervention

C: comparison variable

O: outcomes

PICO example

P: hospitalized patients with grade 2 or 3 pressure ulcers in intensive care

I: insulin dressing

C: normal saline dressing

O: pressure ulcer scale for healing (PUSH), a tool to measure change in pressure ulcer size, exudate amount, and tissue type over time, measured on day 1,4,7

how do we know things?

- tradition: inherited knowledge and accepted precedent

- authority: statements or beliefs or influential leaders

- experience: trial and error in your own practice

components of EBP as a framework for clinical decision making

- best available research evidence

- patient values and preferences

- clinical expertise

process of EBP

1.Ask

2. Acquire-evidence

3.Appraise-make sure not biased

4. Apply-to patient

5. Assess-check performance