2: Methods and evidence

Question 1

What are the two main groups of social science methods?

Answer 1

Quantitative

Qualitative

Question 2

Describe quantitative research

Answer 2

Collection of numerical data which begins as a hypothesis. Conclusions are drawn by deduction, about relationships between variables, sometimes causal.

Question 3

What is quantitative research good at?

Answer 3

Reliable and repeatable. 
Good at
- Describing
- Measuring
- Finding relationships
- Allowing comparisons

Question 4

What are some problems with quantitative research?

Answer 4

• 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 5

List some features of quantitative research

Answer 5

• Numbers
• PoV of researcher
• Researcher distant
• Theory testing
• Static and structured
• Generalisation - factors out of context

Question 6

Describe some quantitative research designs

Answer 6

• Experimental study designs: RCT, cohort, case control, cross sectional
• Secondary analysis from other sources such as official stats and national surverys
• Commonly uses QUESTIONNAIRES

Question 7

Describe important features of quantitative questionnaires

Answer 7

• Valid - measure what they are supposed to
• Reliable - consistent measurement reflecting differences between participants
• Published - tested for validity and reliability. However this must be established in unpublished.
• Mainly closed Qs, may have some free test boxes but need to plan how to analyse

Question 8

Describe qualitative research

Answer 8

Aims to make sense of phenomena in terms of the meaning people bring to them - listens to people’s perspectives.

Question 9

Describe features of qualitative research

Answer 9

Words and artefacts, PoV of participants, researcher close, theory emergent, less structured, contextual understanding

Question 10

What is qualitative research good at?

Answer 10

Understanding perspectives, accessing info not revealed quantitatively, explaining relationships between variables

Question 11

What are some problems with qualitative research?

Answer 11

Small sample sizes and different approaches mean it is not good at finding consistent relationships, and generalisability to whole populations is poor

Question 12

Describe some qualitative research designs

Answer 12

Ethnography: studying human behaviour in its natural context
Observation: removes biased, can be by participants or non-participants
Interviews: semi-structures, facilitative perspective giving
Focus groups: not useful for individual experience, may encourage participation, some topics too sensitive, deviant views inhibited
Document and media analysis: good for historical context

Question 13

Describe qualitative analysis and appraisal

Answer 13

ANALYSIS: ongoing iterative process, inspect data, identify themes, produce specification for themes and assign data to themes.
APPRAISAL: tools for assessing quality - CASP. Transparency around sampling, methods and analysis - audit trail if good.

Question 14

What is evidence based practice?

Answer 14

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

Question 15

What are advantages of EBM and systematic research use?

Answer 15

• Reviews and meta analyses communicate pre-existing evidence
• Address clinical uncertainty, highlight gaps or poor quality research
• Authoritative, generalisable, up to date conclusions
• Save clinicians having to locate and appraise themselves
• Reduce delay between discovery and implementation into practice
• Prevent biased decision making

Question 16

Where can evidence for EBM be found?

Answer 16

• Peer reviewed medical journals
• EBM specific journals
• Cochrane collaboration
• NHS centre for reviews and dissemination
• NHS health technology assessment program

Question 17

What are some practical criticisms of EBM?

Answer 17

• Impossible to maintain and create systematic reviews across all specialities
• Challenging and expensive to distribute and implement findings
• RCTs gold standard buyt hard to blind, and ethical issues
• Choice of outcomes very biomedical
• Good faith from pharm companies
• Organisational systems can not support innovation

Question 18

What are some philosophical criticisms of EBM?

Answer 18

• Does not align with most doctors modes of reasoning - probabilistic vs deterministic causality
• Population level outcomes applied to individual
• Can be seen to legitimise rationing
• Unreflective rule followers
• Professional responsibility and autonomy

Question 19

What are difficulties getting evidence into practice?

Answer 19

• Resources not available to implement change
• Evidence exists but doctors don’t know about it - no incentive to keep up to date
• Doctors know about evidence but don’t use it
• Organisational systems can’t support innovation
• Commissioning decisions reflect different priorities