Research Methods I: Key Terms/Concepts

For test 1

Goal of Triple Aim

1. improving the individual experience of care

2. improving the health of populations

3. reducing the per capita costs of care for populations

quantitative research

• based on a philosophy of logical positivism, in which human experience is assumed to be based on logical and controlled relationships among defined variables. It involves measurement of outcomes using numerical data under standardized conditions.

• may be obtained using formal instruments that address physical, behavioral, or psychological parameters, or by putting subjective information into an objective numerical scale

• advantage of this approach: the ability to summarize scales and to subject data to statistical analysis.

qualitative research

•  strives to capture naturally occurring phenomena, following a tradition of social constructivism

• themes, words, understanding different types of narratives

• focused on the belief that all reality is fundamentally social, and therefore the only way to understand it is through an individual’s experience

scientific method

• based on idea that scientific truths exist and can be studied

• a systematic, empirical, and controlled critical examination of hypothetical propositions about the associations among natural phenomenon

Step 1 of the Research Process: Identify the Research Question

formulating a specific question that provides an opportunity for study

Step 2 of Research Process: Design the Study

• design study and plan method of implementation

• who will be studied and how will they be chosen?

• completion of 1 and 2 will develop research proposal: explains research aims, sampling methods, and ethical considerations

Step 3 of Research Process: Implement the Study

data collection; implement plans designed in steps 1 and 2

Step 4 of the Research Study: Analyze the Data

• reduce and collate information into useful forms for analysis

• involves analyzing, interpreting, and drawing valid conclusions about the obtained data

Step 5 of Research Process: Disseminate Findings

• researchers have a responsibility to share their findings with the appropriate audience so that others can apply the information either to clinical practice or further research

paradigms

set of assumptions, concepts, or values that constitute a framework for viewing reality within an intellectual community

• paradigm shifts: fundamental transitions in the way disciplines think about priorities and relationships, stimulating change in perspectives and fostering preferences for varied approach to research

efficacy

the benefit of an intervention as compared to a control, placebo, or standard program, tested in a carefully controlled environment with the intent of establishing cause and effect relationships

• ideal conditions

  • incorporates random assignment to groups to minimize bias

  • specific Tx protocol

  • strict inclusion and exclusion criteria

effectiveness

the benefits and use of procedures under “real-world” conditions in which circumstances cannot be controlled within an experimental setting

• real world conditions

  • more generalizable

  • Tx more reflective of practice

  • inclusion and exclusion criteria not as strict, ex: allows for comorbidities

International Classification of Functioning, Disability and Health

• portrays health and function in a complex and multidimensional model, consisting of 6 components in 2 domains

• used to reflect potentially needed health services, environmental adaptations, or guidelines that can maximize function for individuals or create advantageous community services

• useful for health promotion, prevention of illness and disability, and for the development of relevant research outcomes

• acknowledges occupations are at the heart of person’s health

intraprofessional

members of one profession work together, sharing information through the lens of their own profession

multiprofessional

an additive process whereby members of multiple professions work in parallel alongside each other to provide input, making complementary contributions, each staying within their own professional boundaries, working separately on distinct aspects of the problem

interprofessional

members of multiple professions work together, contributing their various skills in an integrative fashion, sharing perspectives to inform decision making

systematic reviews vs. meta analysis vs. scoping reviews

systematic reviews	meta-analysis	scoping reviews
present comprehensive analysis of the full range of literature on a particular topic, usually an intervention, diagnostic test, or prognostic factors	step beyond systematic review; applying a process of statistically combining the findings from several studies to obtain a summary analysis	similar to systematic reviews but incorporating a broader range of study designs and data-gathering methods to comprehensively synthesize evidence, often with aims of informing practice, programs, and policy and providing direction to further research
	typically restrict the inclusion of studies based on design criteria to assure a rigorous analysis of the evidence

explanatory vs. exploratory vs. descriptive research

explanatory	exploratory	descriptive
utilizes various types of experimental designs to compare two or more conditions or interventions	observational designs are used to examine a phenomenon of interest and explore its dimensions, often in populations or communities, and to examine how it relates to other factors	researcher attempts to describe a group of individuals on a set of variables, to document their characteristics
Different design approaches offer varied levels of control to establish cause and effect between interventions and outcomes. These trials address both efficacy and effectiveness		may involve the use of questionnaires, interviews, direct observation, or the use of databases.

basic vs. applied research

basic: directed towards the acquisition of new knowledge; includes research in labs on animals; often focused on theory and understanding mechanisms of disease or therapies

applied: clinical research; used to advance the development of new diagnostic tests, drugs, therapies, and prevention strategies

translational research

• the direct application of scientific discoveries into clinical practice

• taking knowledge from “bench to bedside”

randomized control trials (RCTs)

• considered "gold standard” design to study the efficacy of a new therapy by comparing it to a placebo or standard care

• to qualify, 3 conditions must be met:

  1. 2 or more groups, an experimental and a control/comparison group

  2. participants must be randomly assigned to the conditions

  3. an intervention must be applied to the experimental group

pragmatic (practical) clinical trials (PCTs)

incorporate measures of function or quality of life that are considered more relevant for patient satisfaction to understand if Tx have a meaningful effect on patient outcomes

• effectiveness trial used to look at interventions under natural practice conditions to make sure findings from RCTs translate to “real-world care”

practice-based evidence (PBE)

• the systematic collection of patient-reported measures associated with a particular treatment goal or desired outcome.

• considers client based practice

• naturally collecting evidence by doing deeper dives on narrative of the client

• purpose: to objectively understand the relationship between your actions as an OTR and the unique response of your clients on an individual basis

outcomes research

umbrella term to describe studies that focus on the impact of results of healthcare practices and interventions

patient-reported outcome measure (PROM)

any report of the status of a patient’s health condition that comes directly from the patient, without interpretation of the patient’s response by a clinician or anyone else

patient-centered outcomes search (PCOR)

• form of CER

• has distinct goal of engaging patients and other stakeholders in the development of questions and outcome measures, encouraging them to become integral members of the research process

primary vs. secondary outcomes

primary: used to arrive at a decision on the overall result of the study and that represents the greater therapeutic outcome

secondary: other endpoint measures that may also be used to assess the effectiveness of the intervention as well as side effects, costs, or other outcomes of interest

evidence-based practice (EBP)

the integration of clinical expertise, internal and external evidence, and client perspectives to inform clinical decision making

• goal is to create a culture of inquiry and rigorous evaluation that provides a basis for balancing quality with the uncertainty that is found in practice

• evidence does not make the decision, the clinician and patient do that together with the relevant evidence to inform them for optimal shared decision making

internal vs external decision making

internal: as a practitioner, you are still learning; some interventions may "fail"; as you're learning you are understanding and building own internal evidence about what you think works on your own

external: articles; ex: AJOT articles, appraising it to use in practice and copying what they do in your practice

background question

related to etiology or general knowledge about a patient’s condition, referring to cause of a disease or condition, its natural history, its signs and symptoms, or the anatomical mechanisms that relate to pathophysiology

• who what when where why how

foreground questions

more common type of clinical question for EBP; focuses on specific knowledge to inform decision making about patient management; ex: PICO

knowledge translation

• process of identifying clinical problems and accelerating the application of knowledge to improve outcomes and change the provision of care

  • research that’s done gets utilized by the workforce

• involves adaptation of quality research into relevant priorities

  • creation and application of knowledge

• may take years to implement evidence into practice