Health Sciences 2800: Research Methods and Health Epidemiology

Vocabulary practice flashcards covering health research concepts, sampling methodologies, study design, ethics, epidemiology metrics, threats to validity, and confounding from the HS 2800 lecture notes.

Determinants of Health

The biological, behavioural, social, environmental, political, and other factors that influence the health status of individuals and populations.

Health Research

An investigation of health and disease or any of the factors that contribute to the presence or absence of physical, mental, and social health.

Clinical Research

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

Population Health Research

Research that focuses on health outcomes and determinants of health in groups of humans (populations).

Biological Research

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

Demography

The study of the size and composition of population dynamics, such as birth and death rates.

Research

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

Five Steps of Research

1. Identify; 2. Select study approach; 3. Design and collect data; 4. Analyze; 5. Report.

Pre-clinical Research

A type of health research that investigates the safety, mechanism, and potential effectiveness of a drug, therapy, medical device, or other health intervention.

Health Services Research

A type of health research evaluating how social factors, financing systems, organizational structures and processes, health technologies, and personal behaviours affect health care, quality, and cost.

Brainstorming

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

Concept Mapping

The visual listing of ideas and grouping them to reveal relationships.

SKIM Reading

A reading strategy consisting of reading the title, abstract, introduction, headings, first and last sentence of every paragraph, and conclusion, followed by telling a peer what the article was about.

Abstract

A one-paragraph summary of an article, chapter, or book.

SMART Objectives

Objectives defined as Specific, Measurable, Attainable (or Achievable), Relevant (or Realistic), and Timely (or Time-bound).

Research Aim

The overarching goal stating what you want to do (the destination).

Research Objectives

The specific steps detailing how you will accomplish the research aim (the directions).

Good Research Question Criteria

The five essential characteristics: 1. A real question; 2. Testable; 3. Generalizable; 4. Purposeful; 5. Worth answering.

Generalizability

The requirement that research findings must be applicable beyond the study population in order to advance science.

Purposeful (Research Question)

A research question characteristic meaning it is designed to answer one well-defined and specific question.

Inquiry

The process of finding answers to questions that arise from personal experiences.

Testability

The ability of a research question to be answered using experiments or other types of measurements.

Originality

The novel aspects of a new research project that allow it to make a unique contribution to the health science literature.

Replicability

The principle that a study protocol implemented in a new study population should generate results similar to those of the original study, provided the same protocol is used.

EDP Approach

A research question format structuring inquiries as: 'Is [exposure] related to [disease/outcome] in [population]?'

Risk Factor

An exposure that increases an individual's likelihood of subsequently experiencing a particular disease or outcome.

Protective Factor

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

Non-modifiable Risk Factor

A risk factor for a disease that cannot be changed.

Modifiable Risk Factor

A risk factor for a disease that can be avoided or mitigated.

Outcome

An 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.

Primary Prevention

Health behaviours and protective actions that help keep an adverse health event from occurring in individuals who do not already have the condition.

Secondary Prevention

The detection of health problems in asymptomatic individuals at an early stage when conditions have not caused significant damage and can be treated more easily.

Tertiary Prevention

Interventions that reduce impairment, minimize pain and suffering, and prevent death in people with symptomatic health problems.

PICOT

A research framework components: Patient (or Population) and Problem, Intervention tested, Comparison/Control group, Outcome of interest, and Timeframe for follow-up.

Three Levels of Reading

1. Screen (is this article potentially relevant?); 2. Skim (what is this article about, and what did the researchers do and find?); 3. Study (what can I learn from it, and how will I use it?).

Literature Review Structural Formats

Chronological, Major themes, The wheel, and The inverted pyramid.

Confidentiality & Privacy

Anonymizing or de-identifying data, storing data securely, and only sharing information with proper consent.

Respect for Persons and Autonomy

Obtaining informed consent, respecting participants' choices, privacy, and dignity, and providing extra protections for vulnerable populations.

Beneficence

Designing studies that have social or scientific value and ensuring that the research is worth doing.

Justice (Research Ethics)

Fairly selecting participants (avoiding exploitation or exclusion) and distributing the benefits and burdens of research so that no group is unfairly burdened or excluded from benefits.

Integrity and Transparency

Being honest about methods, findings, and conflicts of interest, avoiding fabrication, falsification, or plagiarism, and reporting results truthfully.

Informed Consent

Ensuring participants are fully informed about the study's purpose, procedures, risks, benefits, and right to withdraw without penalty, presented in a voluntary, comprehensible, and documented manner.

Non-maleficence

The ethical duty to do no harm by minimizing physical, psychological, social, and legal risks, ensuring any potential harm is justified by potential benefits.

Ontology

The philosophical study of what constitutes reality and what can be known about it ('What am I looking at?').

Epistemology

The philosophical study of how knowledge is created, developed, and communicated ('The knowledge about reality').

Positivism

A research paradigm that seeks universal, measurable laws based on a single objective reality.

Constructivism

A research paradigm that seeks to understand subjective meanings, contexts, and diverse human experiences.

Positionality Statement

A description of an author's identity in society, especially as it relates to a particular research project.

Macro/Grand Theories and Micro Theories

Mental models designed to understand phenomena and organize complexity (e.g., Karl Marx's theory of Marxism, Game theory).

Theoretical Framework (Models)

A specific or concrete instance of a theory used to map a theory to a research question or phenomenon ('to act').

Conceptual Framework

Applying a particular theory to a particular problem, justified with a literature review and methodology for a specific research study.

Eco-social Model

A model designed to understand human development in the broader ecological and social context ('the Big picture').

Evans & Stoddart Model

A health model asserting that human health is not just about healthcare, but also includes genetics, the physical environment, social environment, and other factors.

Health Belief Model

A psychological model positing that health-related action depends on perceived risk, severity, benefits, barriers, motivation, and confidence.

Target Population

The entire group of people that a researcher wants their study results to apply to.

Source Population (Sampling Frame)

The specific pool of people from whom the sample is selected.

Sample

The group of people approached to take part in the survey or research.

Study Population

The individuals who actually took part in the research study.

Probability Sampling

Selection techniques where the probability of selecting each sampling unit is known, represented as: $\text{Prob}(\text{Sampled}) = \frac{n}{N}$.

Stratified Sampling

A probability sampling technique drawing random samples from distinct subgroups or strata, such as geography (urban, rural, suburban) or sex (female, male, nonbinary).

Cluster Sampling

A probability sampling method where naturally existing clusters (e.g., schools, neighbourhoods) are selected rather than individuals, and observations are made on all units within the chosen clusters.

Multistage Sampling

A sampling method involving hierarchical selection stages: primary sampling units (e.g., municipalities), secondary units (e.g., city blocks), and tertiary units (e.g., individuals).

Convenience Sample

A nonprobability-based sampling method selecting individuals, schools, workplaces, organizations, or communities based on ease of access.

Proper Sample Size Calculation Factors

Calculated based on: 1. Effect estimate of exposure on outcome (larger effect requires smaller sample); 2. Accepted error (smaller desired error requires larger sample); 3. Variation of outcome in population (complex, largest when prevalence is $50\%$).

Type I Error ($\alpha$)

Concluding that there is a treatment effect or an exposure/outcome association when there is not (statistical false positive; 'jumping the gun').

Type II Error ($\beta$)

Failing to detect a real treatment effect or an exposure/outcome association when one actually exists in the source population (statistical false negative; 'missing the boat').

Interview

The process of verbally asking a participant questions and recording their responses.

Self-administered Survey

A questionnaire form that participants complete independently, using either a paper-and-pencil version or an online format.

Closed-ended Questions

Survey questions that allow a limited, fixed number of possible responses.

Open-ended Questions

Survey questions that allow an unlimited number of possible, free-form responses.

Exposure Measurement

Assessing the quantity of a substance or hazard an individual encounters and how much enters the body or affects tissues (measured via available dose, administered dose, absorbed dose, or active dose).

Ratio

A mathematical relationship comparing two numbers where the numerator is not necessarily included in the denominator.

Proportion

A mathematical fraction comparing two numbers where the numerator is necessarily included in the denominator, always ranging between $0$ and $1$.

Odds

The probability of an event occurring relative to the probability of it not occurring.

Rate

A measure of the speed of occurrence of an event over time, calculated with the number of observed events as the numerator and the population at risk over a set time period as the denominator.

Prevalence Rate

The proportion of the population (or population sample) that has a given disease or other attribute at a specified point in time or period of time.

Incidence Rate

The proportion of the population at risk that develops a given disease or new attribute during a specified period of time.

Four Hallmarks of Health Studies

1. A research question or plausible theory; 2. A well thought-out design to address the question; 3. Measurement of exposure and outcome; 4. Analysis to compare groups.

Relative Risk

A metric describing how many times as likely an exposed individual is to experience a health outcome compared to an unexposed individual, indicating the strength of an association.

Random Error

Variability in measurement or sampling caused purely by chance.

Systematic Error

A consistent error in study design, collection, or measurement resulting from a recognizable, non-random source.

Three-Pass Approach (Keshav, 2016)

A paper-reading method: First pass (5–10 min bird's-eye view using the 5 C's: Category, Content, Correctness, Contributions, Clarity); Second pass (<1 hr summarizing aims/objectives); Third pass (reproducing/critically evaluating the paper).

Validity

The accuracy of a measurement or study result (characterized by having fewer systematic and random errors).

Reliability

The consistency and repeatability of a measurement over repeated applications.

Internal Validity

The condition where the effect estimated from the analytic sample is equal to the true causal effect in the study sample.

External Validity

The condition where the true causal effect in the study sample is equal to the true causal effect in the target population.

Threats to Validity (The Big 3)

1. Chance (random sampling error); 2. Bias (selection bias, information bias); 3. Confounding.

Selection Bias

A systematic error in the way participants are selected or retained in a study.

Volunteer Bias

A type of selection bias occurring when volunteers differ systematically from non-volunteers (e.g., being more health-conscious or from a different socio-economic group).

Differential Exposure

A bias that occurs when the probability of being categorized into the wrong exposure group depends on the participant's disease or outcome status.

Healthy Worker Effect

A type of membership bias where working populations experience lower mortality or morbidity rates compared to the general population.

Loss to Follow-up Bias

A selection bias common in clinical trials or longitudinal studies where participants leave the study early in a differential manner (e.g., the sickest individuals withdrawing).

Confounding

A distortion of the actual exposure-outcome association caused by a mixing of effects with an incidental variable known as a confounder, occurring because the exposed and unexposed groups are not exchangeable.

Criteria for a Confounding Variable

1. Causally associated with the outcome (a true risk factor); 2. Non-causally or causally associated with the exposure; 3. Not an intermediate (mediator) on the causal pathway between exposure and outcome.

Assessing Confounding Steps

Step 1: Conceptualize the relationship; Step 2: Think of variables; Step 3: Exclude variables on the causal pathway; Step 4: Identify true confounders; Step 5: Deal with confounders through design and adjustment.

Effect Modification

A phenomenon that occurs when the strength or direction of an exposure-outcome association changes across different levels of a third variable.

Mediation

The role of an intermediary variable that lies directly on the causal chain between an exposure and an outcome, which is distinct from a confounder by definition.