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EVIDENCE-BASED MEDICINE > 3 – Types of Research Studies > Flashcards

3 – Types of Research Studies Flashcards

1
Q

Predatory publishing

A
  • Open access publishing business model
  • Charges excessive publication fees to authors
  • Lack of peer review and editorial oversight
  • May mimic the journal name of a legitimate journal
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2
Q

Bohannon Experiment

A
  • Half the fake ‘peer reviewed’ journals were ACCEPTED
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3
Q

4 questions to ask about a paper that you found

A
  1. Does it have the right study design to answer my question?
  2. Which level of evidence does the paper provided?
  3. Is the quality good enough?
  4. Is the paper relevant to my patient or population?
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4
Q

What kind of studies are done?

A
  • Primary research studies
  • Secondary research
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5
Q
  • Primary research studies
A

o Case reports
o Case series
o Observational studies
 Cohort
 Case-control
 Cross-sectional
o Diagnostic test validity studies
o Experimental studies
o Clinical trials

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6
Q
  • Secondary research
A

o Reveiws
 Narrative reviews
 Scoping reviews
 Systemic reviews
 Meta-analysis
o Economic analyses
 Partial budgets
 Decision analysis

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7
Q

Case report

A
  • ‘a story’
  • Cannot make conclusions regarding efficacy of treatment
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8
Q

Case series

A
  • Outcome of a group of animals with the same disease
  • No disease-free animals for comparison
  • Differences in treatment or management not allocated
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9
Q

Surveys/observational studies

A
  • Random sample from population to obtain an unbiased estimate of variable of interest
  • Available study populations may not always be REPRESEMNTATIVE of true target population
  • If all animals in population are investigated then survey is a ‘census’
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10
Q

Observational studies

A
  • Study species of interest in natural environment
  • Can study rare events in large populations
  • Harder to control for confounding variables
  • Harder to make causal associations
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11
Q

Goals of observational studies

A
  1. Measure disease frequency
  2. Assess distribution of disease
  3. Identify determinants of disease
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12
Q

Two directions to data gathering

A
  • Prospective studies
  • Retrospective studies
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13
Q
  • Prospective studies
A

o Looking FORWARD and getting new data after the start of the study
o Ex. cohort studies

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14
Q
  • Retrospective studies
A

o Looking BACKWARD and using data that has already been collected
o Ex. case-control studies

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15
Q

Cross-sectional studies

A
  • Sample population with no prior knowledge about exposure or disease status
  • ‘snapshot in time’
  • Longitudinal studies
    o Follows the sample population over time to assess for various outcomes
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16
Q

Cross-sectional studies Disadvantages

A

o Weakest observational design
o Don’t know when disease occurred
o Rare events are a problem
o Hard to study quickly emerging diseases

17
Q

Case-control studies

A
  • Separate samples of animals with and without the outcome of interest
  • Easy to preform
  • Prone to more gases
  • Usually retrospective in nature
  • Good for rare or acute diseases
18
Q

Case-control studies strengths

A

o Less expensive and time consuming
o Efficient for studying rare diseases

19
Q

Case-control studies limitations

A

o Inappropriate when disease outcome for specific exposure is not know at start of study
o Disease status can influence selection of subjects

20
Q

Bias in case control studies

A
  • Sampling bias
  • Measurement bias
    o Retrospective nature of ID of exposure to factors
     Recall bias
     Use of blinding so that observers and study subjects don’t know case-control status and risk factors being studied
21
Q

4 strategies for control selection

A
  • Hospital/clinic based controls
  • Matching
  • Population based sample of cases
  • 2 or more control
22
Q

Cohort studies

A
  • 2 samples of subjects selected on BASIS of exposure to some risk factor (with and without the risk factor)
  • Followed through time
  • Less prone to biases
  • Important to ensure validity of exposure, equal follow-up and accurate disease diagnosis
  • *BEST OBSERVATIONAL STUDY
  • Usually prospectively
23
Q

Cohort study strengths

A
  • Exposure status determined before disease detection
  • Subjects selected BEFORE disease detection
  • Study several outcomes for each exposure
24
Q

Cohort study limitations

A
  • Expensive and time consuming
  • Inefficient for rare disease or ones with long latency
  • Loss to follow up can be a major problem
25
Q

Experimental studies

A
  • Maneuver is performed on animal in a CONTROLLED and ARTIFICAL surrounding
  • Often disease is created or induced
  • May use lab species as a model for another species
  • Similar to clinical trials (2 or more interventions are usually compared)
26
Q

Clinical trials

A
  • Interventions given to groups of patients and followed up
  • Comparison/control group is used in parallel (PARALLEL ARM TRIAL)
  • Treatments are randomly allocated
  • Patients NOT in a controlled environment
27
Q

Randomized controlled clinical trial (RCCT)

A
  • Experimental subjects receive new treatment and compared against other subjects (controls: placebo or standard treatment)
28
Q

Advantages of clinical trials

A
  • Can have very specific hypothesis
  • Easier to control confounding variables
    o Eliminates bias if done well
  • more likely to determine causality
  • can still assess species in natural environment
  • allows for meta-analysis at a later date
29
Q

Disadvantages of clinical trials

A
  • expensive and time consuming
  • difficult to perform on rare diseases
  • controlled by large pharmaceutical companies
  • possible to introduce hidden ‘bias’ (rare if trail is carried out correctly)
30
Q

Narrative review and opinion reviews

A
  • traditional review papers
  • if no organized literature search=’opinion’ article
  • literature search not comprehensive or systematic=’narrative’ review
31
Q

Narrative reviews

A
  • tend to cover subset of studies based on availability or author selection
  • can introduce element of ‘selection bias’
  • can be informative, but not as robust as systematic reviews
32
Q

Scoping reviews

A
  • describe available literature on a topic
  • ‘charting’ or ‘mapping’
  • Research question is often broader in nature
33
Q

Systematic reviews

A
  • Standardized and rigours methods to review all scientific literature for a particular PICO
  • Attempts to minimize bias
  • Comprehensive and systematic literature search
  • No combining of data between studies
  • Formally reports search strategies and all source
34
Q

‘grey literature’

A
  • Documents produced on all levels of government, academics, business and industry
  • Publishing is NOT primary activity of the producing body
35
Q

Meta-analysis

A
  • Top of pyramid
  • Apply stats to a systematic review of all clinical trial data
  • Quantitative summary of info obtained
  • Focuses on combined measure of treatment effect
  • Useful to estimate relative importance of different factors affecting outcome of interest
36
Q

Strength ladder of clinical evidence (stronger to weaker)

A
  • Meta-analysis/systematic review
  • Randomized controlled clinical trial
  • Cohort study
  • Case-control study
  • Cross-sectional study
  • Case series
  • Case report

EVIDENCE-BASED MEDICINE (8 decks)

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