OT 341 MIDTERM Review

What is Research?

• Defined as a systematic and principled way to obtain evidence to solve health care problems.

• Research is not limited to formal laboratory settings; it encompasses both formal and informal forms.

• Important for clinicians to inform their practices with current research for optimal care.

Scientific Method

• Involves a rigorous process of acquiring knowledge via systematic analysis, requiring elements of induction and deduction.

• Key assumption: Nature is orderly and events are predictable.

• Importance of controlling extraneous factors for confident research outcomes.

Characteristics and Support of Research

• Characteristics: Rigor, skepticism & empiricism, logic, communality.

• Research Supports Practice: Provides knowledge for therapists, establishes the need for occupational therapy, develops and tests theory.

Evidence-Based Practice (EBP)

• Conscientious, explicit, and judicious use of current best evidence in clinical care.

• EBP utilizes literature along with clinical judgment and patient preferences.

• PICO: a framework for formulating clinical questions (Patient, Intervention, Comparison, Outcome).

Research Process

• Steps: Identify a research question, design the study, implement methods, analyze data, disseminate results.

• Importance of peer-review in validating research.

Types of Research

• Qualitative vs. Quantitative: Qualitative explores experiences via subjects' narratives; quantitative uses numerical data to assess outcomes.

• Types: Descriptive, exploratory, experimental, correlational.

Statistical Analysis

• Types of Data: Nominal, ordinal, interval, ratio.

• Descriptive Statistics: Summarizes data via measures of central tendency and variability.

• Inferential Statistics: Helps generalize findings from a sample to a population, testing hypotheses and relationships between variables.

Research Design

• Types: Basic (theoretical) vs. applied (practical solutions); true experimental designs (randomized trials) vs. quasi-experimental designs (no randomization).

• Reliability and Validity: Essential for ensuring measurement accuracy in research.

Literature Review

• Important for synthesizing existing research, identifying gaps, and contextualizing findings in a broader field.

• Should not be merely a summary or an annotated bibliography; involves critical analysis of themes.

Critical Thinking and Analysis in Research

• Continuous questioning of the validity and reliability of research sources is essential.

• Differentiate between limitations (gaps that impact study) and biases (systematic errors).

Ethical Considerations in Research

• Adherence to ethical standards in research, including Institutional Review Board (IRB) approval, is essential.

• Importance of understanding conflicts of interest and protecting human subjects.

What is Research?

• Defined as a systematic and principled way to obtain evidence to solve health care problems.

• Research is not limited to formal laboratory settings; it encompasses both formal and informal forms.

• Important for clinicians to inform their practices with current research for optimal care.

Scientific Method

• Involves a rigorous process of acquiring knowledge via systematic analysis, requiring elements of induction and deduction.

• Involves elements of inductive reasoning (moving from specific observations to broad generalizations) and deductive reasoning (testing general theories against specific observations).

• Key assumption: Nature is orderly and events are predictable.

• Importance of controlling extraneous factors for confident research outcomes.

Characteristics and Support of Research

• Characteristics: Rigor, skepticism & empiricism, logic, communality.

  • Rigor: Adherence to research methodology to ensure accuracy and consistency.

  • Skepticism: Questioning the validity and reliability of evidence.

  • Empiricism: Reliance on observation and experience.

  • Logic: Sound reasoning and systematic approach.

  • Communality: The commitment to sharing research findings.

• Research Supports Practice: Provides knowledge for therapists, establishes the need for occupational therapy, develops and tests theory.

Evidence-Based Practice (EBP)

• Conscientious, explicit, and judicious use of current best evidence in clinical care.

• EBP utilizes literature along with clinical judgment and patient preferences.

• PICO: a framework for formulating clinical questions (Patient, Intervention, Comparison, Outcome).

• A good research question is important, answerable, and feasible.

Research Process

• Steps: Identify a research question, design the study, implement methods, analyze data, disseminate results.

• Importance of peer-review in validating research and distinguishing good sources.

• The IMRaD structure (Introduction, Methods, Results, Discussion) is a common organizational pattern for scientific articles.

Types of Research

• Qualitative vs. Quantitative: Qualitative explores experiences via subjects' narratives; quantitative uses numerical data to assess outcomes.

• Types: Descriptive, exploratory, experimental, correlational.

• Basic (theoretical) research aims to expand knowledge, while applied research seeks practical solutions.

• Non-experimental research observes phenomena without direct manipulation of variables.

Levels of Evidence

• Refers to a hierarchy of research designs, with systematic reviews and meta-analyses generally providing the highest level of evidence, followed by randomized controlled trials, cohort studies, case-control studies, and expert opinions.

Statistical Analysis

• Why researchers use statistics: To summarize data, test hypotheses, estimate population parameters, and make predictions based on data collected from samples.

• Independent variables are manipulated or chosen by the researcher; dependent variables are the outcomes being measured.

• Types of Data: Nominal, ordinal, interval, ratio.

  • Nominal data: Categories without order (e.g., gender, blood type).

  • Ordinal data: Categories with a meaningful order but unequal intervals (e.g., pain scale, education level).

  • Interval data: Ordered data with equal intervals between values but no true zero point (e.g., temperature in Celsius).

  • Ratio data: Ordered data with equal intervals and a true zero point (e.g., height, weight, age).

• Descriptive Statistics: Summarizes data via measures of central tendency and variability.

  • Measures of central tendency describe the typical value in a dataset:

  • Mean: The arithmetic average of all values.

  • Median: The middle value when data is ordered from least to greatest.

  • Mode: The most frequently occurring value.

  • Measures of variability describe the spread of data (e.g., range, standard deviation, variance).

• Inferential Statistics: Helps generalize findings from a sample to a population, testing hypotheses and relationships between variables.

• Z-scores represent how many standard deviations a data point is from the mean (Z = (X - ar{x}) / s).

Parametric vs. Nonparametric Statistics

• Parametric statistics assume data follow a normal distribution, are interval or ratio scale, and have homogeneity of variance (e.g., t-tests, ANOVA). They are more powerful when assumptions are met.

• Nonparametric statistics are used when these assumptions are violated, or with nominal/ordinal data (e.g., chi-square, Wilcoxon). They do not assume a specific distribution.

Regression Analyses

• Regression analyses examine the relationship between one dependent variable and one or more independent variables, often used for prediction (e.g., predicting a person's weight based on height and age).

Critical Literature

Literature Review

• Important for synthesizing existing research, identifying gaps, and contextualizing findings in a broader field.

• Should not be merely a summary or an annotated bibliography; involves critical analysis of themes.

• Grey literature refers to research produced outside traditional commercial or academic publishing and distribution channels (e.g., government reports, theses, conference proceedings). It often provides original interpretation but may require more critical evaluation.

• A good source is typically peer-reviewed, current, relevant, and from reputable authors or institutions.

• The original interpretation of the literature takes place in peer-reviewed scientific articles, particularly in the discussion section, where authors provide their insights on findings.

Reading and Evaluating Literature

• Effective reading strategies include scanning (quickly looking for keywords or specific information), skimming (reading for main ideas and overall structure), and close reading (thorough, analytical reading for deep understanding and critical evaluation).

• Evaluating a source involves assessing its credibility (authors, publication, peer-review), methodology (design, execution, bias), and relevance to your research question.

Critical Thinking and Analysis in Research

• Continuous questioning of the validity and reliability of research sources is essential.

• Differentiate between limitations (gaps that impact study) and biases (systematic errors).

Ethical Considerations in Research (IRB)

• Adherence to ethical standards in research, including Institutional Review Board (IRB) approval, is essential.

• The Institutional Review Board (IRB) is a committee that reviews and approves research involving human subjects to ensure ethical conduct. Its purpose is to protect the rights and welfare of research participants.

• Key ethical principles in human subjects’ research include respect for persons (autonomy, informed consent), beneficence (maximizing benefits, minimizing harm), and justice (fair distribution of risks/benefits).

• IRB approval is required before any research involving human subjects begins, with timelines varying based on the study's risk level and ethical considerations.

• Ensuring confidentiality (managing information so individual identifiers are not linked to responses) and anonymity (i.e., not even the researcher can link data to an individual) of participant data is crucial.

• Researchers must carefully weigh the benefits vs. costs (e.g., risks and burdens) of the research for participants and society.

Research Design

• Types: Basic (theoretical) vs applied (practical solutions); true experimental designs (randomized trials) vs quasi-experimental designs (no randomization).

• Reliability and Validity: Essential for ensuring measurement accuracy in research.

Validity in Quantitative Research

• Internal validity: The extent to which a study establishes a trustworthy cause-and-effect relationship between the treatment and outcome, free from confounding variables.

• External validity: The extent to which the findings can be generalized to other populations, settings, or times.

• Types of validity in quantitative research include:

  • Face validity: Appears to measure what it's supposed to (i.e., the content of the measure seems to reflect the construct being measured).

  • Content validity: Covers all relevant aspects of the construct (i.e., the instrument adequately samples the domain of interest).

  • Criterion validity: Correlates with an external criterion.

  • Concurrent validity: Measure correlates well with a validated measure administered at the same time.

  • Predictive validity: Measure successfully predicts future outcomes.

  • Construct validity: Measures the theoretical construct it intends to measure.

  • Convergent validity: Measure correlates strongly with other measures of the same construct.

  • Divergent validity: Measure correlates weakly or negatively with measures of different constructs.

Participant Selection and Sampling

• Careful participant selection is vital for research integrity, ensuring the sample is appropriate for the research question.

• Sampling bias occurs when some members of a population are systematically more likely to be selected than others, leading to a non-representative sample.

• Probability sampling (random methods): Every element in the population has a known, non-zero chance of being selected, enhancing generalizability.

  • Simple random sampling: Every member has an equal chance.

  • Stratified random sampling: Population divided into subgroups (strata), then random samples taken from each.

  • Cluster sampling: Population divided into clusters, then whole clusters are randomly selected.

  • Systematic sampling: Selecting every nth individual from a list.

• Non-probability sampling (non-random methods): Does not guarantee every element has a chance of selection, often used in qualitative research or specific contexts where random selection is not feasible.

  • Convenience sampling: Selecting participants who are readily available.

  • Purposive sampling: Selecting participants based on specific characteristics relevant to the research question.

  • Quota sampling: Selecting participants until a certain number (i.e., quota) of different types of participants has been obtained.

  • Snowball sampling: Participants recruit other participants from their network.

Reliability in Quantitative Research

• Reliability refers to the consistency and reproducibility of a measure or observation.

• Types of reliability include:

  • Test-retest reliability: Consistency of a measure administered to the same individuals over time.

  • Intrarater reliability: Consistency of one rater or observer across multiple measurements or observations.

  • Interrater reliability: Consistency between two or more different raters or observers.

  • Alternate forms reliability: Consistency across different versions or forms of a measure (e.g., Form A vs. Form B of a test).

  • Internal consistency: Consistency among items within a measure (e.g., how well different questions on a survey measure the same underlying construct, often measured by Cronbach's alpha).

Measurement Errors and Generalizability

• Types of measurement errors:

  • Systematic errors: Consistent and repeatable inaccuracies inherent in the measurement system or design, leading to bias (affect accuracy).

  • Random errors: Unpredictable and fluctuating inaccuracies, often due to chance (affect precision).

• Generalizability: The applicability of research findings to a broader population or context beyond the study sample.

• Minimal Detectable Difference (MDD) or Minimal Detectable Change (MDC): The smallest change in an outcome measure that is greater than the standard error of measurement and reflects a real, not random, change in an individual's status.

• Minimal Clinically Important Difference (MCID): The smallest change in an outcome measure that is perceived as beneficial or important by the patient and indicates a meaningful improvement in their condition.

Systematic Reviews and Meta-analyses

• Systematic reviews are comprehensive syntheses of existing research on a specific question, using explicit and rigorous methods to identify, select, and critically appraise studies. What makes them unique is their objective, reproducible process designed to minimize bias and provide a thorough summary of evidence.

• Meta-analysis is a statistical technique that combines the quantitative results from multiple studies included in a systematic review to produce a single pooled estimate of the effect. It is unique in its statistical integration, providing greater statistical power and precision than individual studies, allowing for stronger conclusions.

Randomized Controlled Trials (RCTs)

• An RCT is considered the gold standard for true experimental designs to test the effectiveness of interventions. Participants are randomly assigned to an intervention group or a control group to minimize bias and allow for direct comparison.

• Independent variables are the interventions being tested (e.g., new drug, specific therapy), and dependent variables are the measured outcomes (e.g., disease reduction, functional improvement).

• Randomized sampling is a key method, ensuring that each participant has an equal chance of being assigned to any group, thus helping to create groups that are comparable at baseline.

• A blinded study helps reduce bias: a single-blinded study means participants do not know which group (e.g., treatment or placebo) they are in; a double-blinded study means neither participants nor the researchers/data collectors know group assignments.

Qualitative Research

• Characteristics of qualitative research include a focus on understanding meaning from the participant's perspective, naturalistic settings, inductive reasoning, iterative data collection and analysis, and the researcher as a key instrument.

• Key differences between qualitative research and quantitative research are the nature of data (narrative, textual, observational vs. numerical), research questions (exploring a phenomenon, experiences vs. testing a hypothesis, measuring relationships), sample size (usually smaller, purposive vs. larger, representative), and analytic approaches (thematic analysis vs. statistical tests).

• The role of subjectivity in qualitative research is acknowledged and often embraced, as researchers interpret data from their own lens while striving for reflexivity and grounding interpretations in participant experiences.

• How to reach conclusions and report results in qualitative research: Involves identifying themes, patterns, and categories from textual or observational data, leading to rich descriptions, narratives, or theoretical models explaining the phenomenon. Results are often presented with direct quotes from participants.

• Critical guidelines for sampling in qualitative research: Typically uses purposive sampling (selecting information-rich cases) or convenience sampling, aiming for depth of understanding rather than statistical generalizability. Sample size is determined by saturation, meaning no new themes emerge from additional data.

• Types of research designs in qualitative research:

  • Phenomenology: Explores the lived experiences of individuals related to a phenomenon.

  • Ethnography: Studies the culture and social interactions of a group in their natural setting.

  • Grounded theory: Develops a theory from systematically gathered and analyzed data.

  • Case study: In-depth investigation of a single case or small number of cases.

• Types of data collection in qualitative research procedures: Interviews (individual or focus groups), observations (participant or non-participant), document analysis, and visual methods (e.g., photos, videos).

• Approaches can be structured (predetermined questions, less flexible), semi-structured (guide with flexibility for probing), or open-ended (conversational, emergent questions).

• Content analysis: A systematic approach to analyze textual data (e.g., interviews, documents) to identify patterns, themes, or biases.

• Types of rigor in qualitative research (often framed as trustworthiness):

  • Credibility: The findings are believable and authentic from the perspective of the participants (e.g., prolonged engagement, triangulation, member checking).

  • Transferability: The extent to which the findings can be applied or transferred to other contexts or settings (analogous to external validity, achieved through thick descriptions).

  • Dependability: The consistency and stability of the findings over time and across researchers (e.g., audit trail, expert review).

  • Confirmability: The neutrality or objectivity of the findings, ensuring they are based on participants' experiences rather than researcher bias (e.g., reflexivity, triangulation).

Searching for Scientific Evidence

• Critical searching for literature involves using efficient and effective strategies to locate relevant and high-quality evidence, systematically combining keywords and filters.

• Boolean searching uses operators (AND, OR, NOT) to combine or exclude keywords and refine search results.

  • AND: Narrows results (retrieves articles containing all specified terms).

  • OR: Expands results (retrieves articles containing any of the specified terms).

  • NOT: Excludes results (retrieves articles containing the first term but not the second).

• Various types of databases specialize in different fields and offer specific search functionalities:

  • Health and Medical: PubMed, CINAHL, Cochrane Library, Embase.

  • Psychology: PsycINFO.

  • Education: ERIC.

  • Interdisciplinary: Web of Science, Scopus, Google Scholar.