2nd lecture Flashcards
What are the 5 A’s?
Ask
Acquire
Appraise
Apply
Assess
Where can we find evidence?
scientific journals, magazines, government and pro websites, Grey literature
What is scientific journals?
typically peer reviewed - higher credibility
What is peer reviewed?
meaning that the stuff is scrutinized by experts before published to assure a level of quality
What magazines, non peer reviewed source are we talking about here?
provide useful summaries of info in the progression to give DIRECTION for further inquiry
What do we mean by Government and pro websites?
National Institutes of Health (NIH) website; AAPA website www.aapa.
APTA website www.apta.org
What do we mean by Grey literature?
government documents, fact sheets; provide demographic statistics,
org;
preliminary data on new intervention that is not made for publication
(unpublished data)
Primary vs. Secondary Sources
of Evidence
Primary sources are reports provided
directly by the investigator
* Examples – research articles in journals,
presentations at professional meeting,
and dissertations
Secondary sources include reviews of
studies presented by someone other
than the original author.
* Examples – review articles and
textbooks
What are primary sources of evidence?
are reports provided DIRECTLY by the investigator
examples, research articles in journals, presentations at professional meeting and dissertations
What do we mean by secondary sources of evidence?
these include reviews of studies presented by someone other than the author
examples review articles and textbooks
what could be a characteristic of non credible sources?
newspapers, non academic magazines and trade journals, if few or no references cited, self referenced, if a product is being delivered, glossy images, if the intended audience is everyone, may provide bias only one opinion, if content is in plain English - usually shorter and doesn’t have abstract or specific language
examples of good search engines / databases?
▪ MEDLINE Complete and PubMed
▪ Cochrane Library
▪ UpToDate
▪ CINAHL Complete (The Cumulative Index to Nursing and Allied Health
Literature)
is google a good research spot?
NO, not synonymous
When you are to ACUIRE evidence, will you be satisfied with your search on 1st try?
rarely, successful searches require several attempts - revising search terms/keywords to broaden or narrow down the search and using different databases
When do you use AND / OR during search ?
AND to be more specific
OR to be more broad
I need to decrease my results of my search?
get more specific - low back pain instead of back pain
include additional terms
side bar filters - date, full text, article type
If i need more results for my search?
- On the abstract page for a citation,
see the Similar Articles
section for
a pre-calculated set of additional
PubMed citations closely related to
that article. - Remove extraneous or specific
terms from the search box. - Try using alternative terms (or
synonyms) to describe the
concepts you are searching.
What is research ?
Clinical research isa structured process of investigating facts and theories and exploring connections with the purpose of improving individual and public health (portney, 2020)
What are the phases of research process?
▪ Phase 1: Identify the
Research Question
▪ Phase 2: Design the Study
▪ Phase 3: Implement the Study
▪ Phase 4: Analyze the Data
▪ Phase 5: Disseminate Findings
ASK ______ APPRAISE APPLY ASSESS
What is missing?
ACQUIRE relevant literature
ASK
ACQUIRE
APPRAISE
________
ASSESS
What is missing?
APPLY
_______ ACQUIRE APPRAISE APPLY ASSESS
What is missing?
ASK
- According to Purpose of Research
Descriptive Research
Exploratory Research
Explanatory Research
FUNDAMENTALS OF RESEARCH
Category of research
- According to “Purpose of research”
▪ Descriptive, Exploratory, and Explanatory - Based upon the Approach of Research
▪ Quantitative & Qualitative Research - Degree of manipulation/Control of Researchers
▪ Experimental & Non-Experimental Research
(according to purpose of research)
what is descriptive research?
To document nature and characteristics of
phenomena through systematic collection of
data
(according to purpose of research)
What is exploratory research?
To investigate relationships between or among
variables
; Usually involves one group of
subjects with measurements taken of different
variables– mathematical relationship is
established among the variables
(according to purpose of research)
What is explanatory research?
To compare differences in outcome measures
between/among different treatments or
conditions
What are variables?
Independent variables (IV)
Dependent variables (DV)
is a variable based on how it will be used in a particular study; how an IV will be
manipulated, and/or how a DV will be measured
Independent variable (IV)
Intervention(s) or treatments
Dependent variable (DV)
Outcome(s) e.g., pain, dizziness, abnormal
blood pressure
Based upon the Approach of Research
Quantitative research?
Research with measurement of outcomes
using numerical data under standardized
conditions; e.g.,
“What is your pain level on a scale: 0 to 10?”
Based upon the Approach of Research
Qualitative research?
Research that derives data from observation,
interview or verbal interaction and focuses on
the meaning of experience of the participants;
e.g.,
“Describe the nature and type of the pain you
experience.”
According to degree of manipulation/control of
researchers
Experimental research?
the design in which the investigator
manipulates the independent variable; e.g.,
➢randomly assigning subjects to groups;
➢managing dose or frequency of medication/therapy;
A cause-and-effect relationship can only be
established by an experimental design!
According to degree of manipulation/control of
researchers
Non-experimental research
Researcher does not control/manipulate/alter
the independent variable or subjects, but relies
on interpretation, observation or interactions
to come to a conclusion. e.g.,
* Survey research; correlational study
Step 3: Appraise the Literature
Once evidence is acquired, it must be critically
appraised to determine whether it meets quality
standards and whether the findings are meaningful
and relevant to the clinical question.
▪ There are 3 major categories of appraisal questions
(Table 5-3; Table 36-2):
1) Is the study valid?
2) Are the results meaningful?
3) Are the results relevant to my patient?
There are 3 major categories of appraisal questions
1) Is the study valid?
2) Are the results meaningful?
3) Are the results relevant to my patient?
“Anatomy” of research article
- Title
- Abstract
Body of the text (word limits applicable) - Introduction
- Methods (KEY to appraising evidence)
- Results (Narratives and Tables and/or
Figures) - Discussion & conclusion
- References
“Functionality” of each element of a
research article
Introduction -
- Define main problems underlying the study
- Identify the knowledge gap in the literature
- Provide rationale for a need of the study (i.e., setting a
stage for the need) - Present the research hypothesis to be tested (for
intervention study) - State the specific purposes/objectives of the study
A research “question” is not always phrased as a
question. Authors may state the purpose/aim of the
study or specific hypotheses! (Portney 2020, Ch 36)
“Functionality” of each element of a
research article
Methods -
- Describe the conduct/performance of the study, and sub
divided into
▪ Subjects/Participants - Who were the subjects? Inclusion/exclusion criteria?
▪ Design - Is it appropriate for answering the research question?
- Was bias sufficiently controlled such as use of blinding?
▪ Instrument/Evaluation - How have the authors documented the reliability and validity of the
instruments for outcome measures?
▪ Procedure - Were data collection procedures described clearly and in sufficient
detail to allow replication? Operationally defined?
▪ Data analyses - How were data analyzed? Analyzed appropriately?
- What statistical tests were used? Were they appropriate to the research
question?
▪Summarized as W&H questions: - Who
- Where: site of performance; Institutional
Review Board (IRB) or ethical approval - What: Procedures/Protocol (tests or
treatments) - How: data analyses
1) Is the study valid?
“Functionality” of each element of a
research article
▪Results
- Report the findings of the study without interpretation or
commentary (fact only) - Answer questions in the order of the stated purposes in the
text (often accompanied by tables/figures) - Present the outcome of statistical analyses
2) Are the results meaningful? - Is the sample sufficiently representative of the target
population so that results can be generalized? - Is the effect large enough to be clinically meaningful?
“Functionality” of each element of a
research article
▪ Discussion
- Present authors’ interpretation of the results
- Compare results with previous pertinent studies (in agreement or
in contrast) - Indicate limitations of the study
- Discuss the relevance to clinical practice
- Suggest future directions
“Functionality” of each element of a
research article
▪ Conclusion
- Restate the findings of the study with respect to the purpose or
hypothesis outlined in the introduction
3) Are the results relevant to my patient?
▪ Were the subjects in the study sufficiently similar to my
patient?
▪ Is the approach feasible in my setting and will it be
acceptable to my patient?
“Functionality” of each element of a
research article
