2) Methods and Evidence

Question 1

Why is social research into health and illness important?

Answer 1

So we can be confident that we have the correct answer to social problems (act, behave, interact). These answers will decide the practices (and therefore policies) of health care professionals.

Question 2

What are quantitative social research methods good for?

Answer 2

• Describing
• Measuring
• Finding relationships between things
• Allowing comparisons
• Reliability and repeatability

Question 3

What are some of the problems with using quantitative social research methods?

Answer 3

• May force people into inappropriate categories
• Don’t allow people to express things in the way they want
• May not access all important information
• May not be effective in establishing causality

Question 4

Define quantitative research.

Answer 4

The collection of numerical data which begins as a hypothesis

Question 5

Suggest some of the difficulties of getting evidence into practice.

Answer 5

-Resources not available (can’t afford it, haven’t got the manpower etc.)
-Evidence exists, but doctors don’t know about it
(not up to date, not enough advertising)
-Doctors know about evidence but don’t use it (habit, professional judgement etc.)
-Organisational systems cannot support innovation
(managers lack the authority to invoke changes necessary etc.)
-Commissioning decisions reflect different priorities
(patients want other things etc.)

Question 6

Suggest different ways in which quantitative research can be carried out.

Answer 6

• Questionnaires
• New (experimental) studies such as RCT, cohort and case control studies
• Analysis of data from other sources such as official statistics, the cenus and surveys

Question 7

What name is given to the type of question commonly used in a questionnaire?

Answer 7

Closed question

Question 8

What do we mean if we describe a questionnaire as valid?

Answer 8

The questionnaire measures what it’s supposed to measure.

Question 9

What do we mean if we describe a questionnaire as reliable?

Answer 9

It measures things consistently and any differences in results come from differences between participants, not from differences between understanding of questions or interpretation of responses.

Question 10

Suggest some of the main differences between qualitative and quantitative research.

Answer 10

• Quantitative gives a number value, whereas qualitative gives words and descriptions
• Quantitative discusses the point of view of the researcher, whereas qualitative focuses on the point of view of the participant
• Quantitative tests a theory, whereas, qualitative creates a theory

Question 11

What are the main strengths of qualitative research?

Answer 11

• Gives an understanding of the perspective of those in a situation
• Accessing information not revealed by quantitative approaches (thoughts, feelings)
• Explaining relationships between variables (can see a relationship in quantitative but can’t figure out why it exists)

Question 12

What are some of the problems with using qualitative methods of research?

Answer 12

• Not good at finding consistent relationships between variables (can’t really repeat it to get the same views)
• Issues with generalisability (good at identifying a range of views on an issue, but dangerous to infer these views from a small sample to the population as a whole)

Question 13

Describe the main designs of qualitative research.

Answer 13

• Ethnography and observation allows to see a group and infer things from what they say/do as opposed to relying on them to tell you.
• Interviews (conversation with a structure, encourages participants to give their views)
• Focus groups allow for determining how much a group understands of an issue.
• Documentary and media analysis to see what the different perspectives are

Question 14

What is evidence-based practice?

Answer 14

The integration of individual clinical expertise with the best available external clinical evidence from systematic research.

Question 15

Before evidence-based practice was introduced what were practices mainly influenced by?

Answer 15

• Professional opinion
• Historical practice and precedent
• Organisations and social culture

Question 16

What are the benefits of systematic research?

Answer 16

• Address clinical uncertainty and highlight gaps or poor quality in research
• Authoritative, generalisable and up to date conclusions that can be applied
• Save clinicians from having to locate and appraise the studies for themselves
• Reduce delay between research discoveries and implementation
• Help prevent biased decisions being made

Question 17

What are some of the practical criticisms given to evidence based medicine?

Answer 17

Practical:

• Hard (if not impossible) to use/update systematic reviews across all specialities
• Challenging and expensive
• Sometimes unethical
• Population-level outcomes may not apply to an individual
• Choice of outcomes often very biomedical, which may limit which interventions are trialled, and therefore which are funded

Question 18

What else must be taken into account other than the conclusions of evidence based medicine?

Answer 18

• Patient’s preferences
• Situation
• Professional clinical judgement

Question 19

What are the benefits of using evidence based medicine?

Answer 19

• Not just guesswork/assumptions

- Know how much you get for how much you pay

Question 20

Why are systematic reviews needed?

Answer 20

• Not easy to see how studies were identified for review in traditional, “narrative” literature reviews
• Address clinical uncertainty
• Highlight gaps in research/poor quality research

Question 21

Suggest sources where you can get systematic reviews from?

Answer 21

• Medical journals
• Cochrane collaboration
• NHS Centre for Reviews and Dissemination
• NIHR Health Technology Assessment Programme

Question 22

What are the two characteristics of a questionnaire that indicate whether it is good?

Answer 22

• Valid

- Reliable

Question 23

What are the main advantages of ethnography and observation?

Answer 23

• Gain access to behaviour of which individuals themselves may provide biased accounts, or indeed be unaware
• Observational methods allow the recording of mundane/unremarkable events (to participants) that interviewees might not feel were worth commenting on and the context within which they occur

Question 24

What are some of the philosophical criticisms given to evidence based medicine?

Answer 24

• Might stop doctors from thinking for themselves
• Removes professional responsibility/autonomy in some cases
• Undermine trust in the doctor-patient relationship

Question 25

What is ethnography?

Answer 25

Observation of people doing what they do normally, without relying on them to tell the truth about what they do. (think about those fatties on secret eaters who say they only ever eat fruit and then get caught eating 8 Big Macs)