Health Sciences

Question 1

What does rigor in qualitative research consist of?

Answer 1

Credibility, transferability, dependability and confirmability

Question 2

Credibility

Answer 2

• Data triangulation, methodological triangulation, investigator triangulation and theory triangulation
• Prolonged data collection
• Member checking

Question 3

Transferability

Answer 3

• Thick description
• Explain sampling strategy
• Discuss findings with existing literature from different settings

Question 4

Dependability

Answer 4

• Data saturation
• Iterative data collection
• Iterative data analysis
• Flexible emergent research design

Question 5

Confirmability

Answer 5

• Search literature that disconfirms findings
• Peer debriefing
• Reflexivity
• Audit trail

Question 6

Example of selection bias

Answer 6

In an RCT for a hypertension drug, participants are recruited through a fitness magazine, leading to a sample of health-conscious individuals. The sample isn’t representative of the broader hypertension population, potentially leading to misleading conclusions.

Question 7

Example of performance bias

Answer 7

In a double-blind pain relief medication trial, nurses know which group participants are in, potentially leading to performance bias. They may unintentionally offer more support to the experimental group, such as frequent check-ins and additional pain relief measures, even if the medication isn’t more effective.

Question 8

Example of attrition bias

Answer 8

In a long-term smoking cessation study, some participants who struggled the most with quitting drop out, creating attrition bias. This skews the results as those who dropped out had different experiences. Dropouts are related to the study’s outcome (quitting smoking), potentially overestimating the effectiveness.

Question 9

Example of detection bias

Answer 9

In a study comparing a new breast cancer screening test to the standard one, radiologists, aware of the research, may inadvertently interpret results more cautiously. This can lead to more false negatives in the new test group. Measurement differs between the groups due to radiologists’ awareness, potentially underestimating the new test’s accuracy.

Question 10

How do you deal with selection bias?

Answer 10

• Random sequence generation
• Allocation concealment

Question 11

How do you deal with performance bias?

Answer 11

• Blinding of participants and personnel

Question 12

How do you deal with attrition bias?

Answer 12

• Be transparent about incomplete outcome data
• Intention-to-treat analysis

Question 13

How do you deal with detection bias?

Answer 13

• Blinding of the outcome assessment

Question 14

What do you look at when assessing the quality of an RCT?

Answer 14

• Criteria for internal validity: RoB
  (randomization, blinding)
• Criteria for external validity: generalizability
  (in- and exclusion criteria)
• Criteria for precision: accuracy
  (sample size)

Question 15

True or false? A content analysis is deductive.

Answer 15

True

Question 16

True or false? A Grounded theory analysis is inductive.

Answer 16

True

Question 17

True or false? Absolute risk reduction (control risk - experimental risk) is the best way to show the risk in a study.

Answer 17

True

Question 18

Why should you be skeptical if only relative risk reductions are shown?

Answer 18

Because this could make the effect of a study look more positive (effective) than it really is.

Question 19

What does deductive reasoning look like?

Answer 19

Theory - hypothesis - data collection - confirmation, rejection, modification

Question 20

What does inductive reasoning look like?

Answer 20

Data collection - analyses of patterns - hypothesis - theory

Question 21

What is participatory action research?

Answer 21

Minimizing the gap between research and society.
- To minimize power differences
- Increase knowledge of participants
- Promote social change

Question 22

Transdisciplinary research consists of:

Answer 22

Participatory action research and interdisciplinary approach

Question 23

Definition and example of content validity

Answer 23

The extent to which the measurement covers all aspects of the concept being measured.
Example:
Suppose researchers want to create a math assessment test for elementary school students. To ensure all the right mathematical concepts and skills are in this assessment, they define the content domain. Other testing tools: expert review, pilot testing and refinement.

Question 24

Definition and example of criterion validity

Answer 24

The extent to which the result of a measure corresponds to other valid measures of the same concept (golden standard).
Example:
Imagine a pharmaceutical company is conducting a study to assess the effectiveness of a new drug designed to reduce blood pressure in hypertensive patients. To establish criterion validity for the new drug’s efficacy, they select a criterion measure (golden standard) to measure blood pressure. If the new drug demonstrates a significant reduction in blood pressure compared to the control group, it can be considered to have good criterion validity for its intended purpose.

Question 25

Definition and example of construct validity

Answer 25

The adherence of a measure to existing theory and knowledge of the concept being measured. Example: Suppose researchers want to develop a questionnaire to measure psychological well-being. To establish construct validity, they develop a theoretical framework that defines psychological well-being, including key components. Researchers use factor analysis to determine whether the items group together in ways that align with the theoretical framework.

Question 26

Researchers ask participants to fill out the questionnaire today and in one week from now. What reliability measure is used and do you recognize bias?

Answer 26

- Test-retest reliability - Since it's only one week, there is a risk of recall-bias

Question 27

In a study on the HRQoL a questionnaire is used. Researchers state in their article that the Chronbach's alpha is 0.92. What is your opinion on this?

Answer 27

- Chronbach's alpha is a measure for the inter relatedness (reliability): do items more or less measure the same construct? 0.92 means high internal consistency. - It is a one dimensional scale! - Researchers should have reported on the outcome of the factor analyses!

Question 28

When do you use interviews?

Answer 28

To understand experiences, opinions, attitudes, values and processes

Question 29

When do you use non-participant observations?

Answer 29

To provide data on phenomena (behavior), as well as people's accounts of those phenomena

Question 30

When do you use ethnography and participant observation?

Answer 30

To understand cultural phenomena that reflect the knowledge and meanings that guide cultural groups

Question 31

When do you use focus groups?

Answer 31

To elicitate information about views of a group and stimulate interactions and discussions

Question 32

When do you use visual research methods?

Answer 32

To interpret the world through the participant's sight and help provide insights into difficult issues

Question 33

When is respondent-assisted sampling useful? What are the risks?

Answer 33

- For hard-to-reach populations - Bias if recruits share common characteristics - Limited generalizability

Question 34

What is publication bias? Give an example

Answer 34

When studies with statistically significant or positive results are more likely to be published, while studies with non-significant or negative results are often left unpublished (overestimation) Example: Imagine a pharmaceutical company conducts a series of clinical trials to test the effectiveness of a new drug for Alzheimer’s disease. It is found to have no significant impact. However, the company decides not to publish the results of the negative trials and only submits the positive trial results to journals. As a result, a systematic review conducted on the published literature might conclude that the drug is highly effective, even though unpublished data reveals a different picture.

Question 35

What is language bias? Give an example

Answer 35

Studies published in one or a few languages are favored over studies published in other languages. Valuable data from studies in these excluded languages may be missed, potentially leading to incomplete results. Example: RCTs in Chinese language favor acupuncture. If not included, results of systematic review might underestimate the effect.

Question 36

What is location bias? Give an example

Answer 36

When researchers focus on studies conducted in specific geographic regions or countries while neglecting studies conducted in other locations. Example: A research team is conducting a systematic review on the dietary habits and their impact on heart disease. They primarily focus on studies conducted in Western countries, such as the US, Canada and EU, and include data from these studies in their review. However, they neglect to include studies from regions like Southeast Asia, where diets and lifestyle factors may significantly differ.

Question 37

Some studies in your systematic review have different study methodologies (2 studies have comparable groups at baseline and 3 don't). What do you do?

Answer 37

You can find out whether this difference does have an impact on the overall outcome by a sensitivity analysis.

Question 38

Why would you do a meta analysis?

Answer 38

To increase power and to improve precision.

Question 39

What could you do to explore heterogeneity?

Answer 39

Subgroup analysis