Research Methods and Analytical Procedures Flashcards
Hierarchy of Evidence (Weakest to strongest)?
Expert opinion
Case Reports
Cohort studies / Cross-sectional Studies
Randomised controlled trials
Systematic Reviews
Whats a narrative review?
While narrative reviews are often written by experts it is likely that his/her expertise, experience and beliefs will influence which studies are included in the review
Narrative reviews do NOT influence policy makers as they are NOT ‘good science’, even if the studies they include are individually very good science.
So falls under Expert opinion, it is cherry picking
What are systematic review?
Systematic reviews minimise the likelihood of such bias as the methods used to identify, select and critically appraise relevant primary research, is done in an open, explicit and systematic way.
Aim of a systematic review?
Summarise the findings of ALL studies that address a very specific research question and meet clear inclusion criteria (e.g. must be RCT, >1 mth). And, if possible, quantify the average effect or finding.
Identify gaps or under-researched areas in the literature (e.g. there maybe a shortage of trials in a particular age group, ethnicity, or sport).
Search term used when doing a systematic review? (example for assessing the impact of exercise referral schemes on physical activity and health outcomes
PICOS
Participants - (Has/risk of disease, old, obese)
Intervention type - (exercise referral)
Control/Compared to - (usual advice, diet)
Outcome - (BMI, BP, physical activity)
Study design - (RCT, cohort, cross-sectional)
PECOS for observational studies - P = population, and E = exposure
Types of systematic reviews?
A qualitative synthesis of the studies: these are quite descriptive. They report the number or proportion of studies that report a statistically significant difference – p<0.05 (systematic review)
A quantitative synthesis of the studies. An ‘average’ intervention effect is calculated from all of the intervention effects from the included studies (systematic review and/with meta-analysis)
Description of a Meta Analysis?
The general aim of a meta-analysis is to more powerfully estimate the ‘true’ intervention effect size as opposed to a less precise effect size derived in a single study.
To produce an ‘average’ intervention effect the units need to be same across all studies, or standardised:
[e.g. Diff of Means divided by Pooled SD].
If there is high heterogeneity (wide range) of effect sizes (e.g. some zero effect, some very positive) then producing a single summary estimate is not appropriate (low I2 value = low heterogeneity = effects were similar across studies). This is a score on the forest plot as well (0% is very low heterogeneity,
Notes about a forest plot for a meta analysis?
Is in chronological order In terms of publication date - done in this order as pilot studies normally show more effects than in real world
Square indicates relative risk of each study. Relative risk shows the percentage increase or decrease the study had
The wings represent the 95%CI, if wings cross the line of ‘no effect’ (relative risk ratio=1) then that study did not find a statistically significant effect.
Relative risk found by (the percentage of those who met the criteria who had the intervention) / the percentage of those who met the criteria who didn’t have the intervention)
Bigger studies will have a greater weighting when determining the ‘average intervention effect’. Instead of each having equal weighting represented by a larger rectangle
The kite/diamond shape at the bottom represents the ‘weighted average’ intervention effect and 95%CI. (the amount 1 represents how much % it increases it by) - and if it crosses the line then it is not significantly different (the size of the diamond is its confidence intervals) - can read of the p value (if lower than 0.05) to check significance as well
What differences could come up if you did a quantitative synthesis/ meta-analysis, compared to a qualitative synthesis?
If looked at studies qualitatively, could end up saying all the studies aren’t significant, but when you look at them qualitatively as a collective they actually make the result significantly
Standard criteria for assessing quality/ risk of bias in forest plots?
e.g. Newcastle-Ottawa risk of bias scale:
0-3 = very high risk
4-6 = high risk
7-9 = low risk
Or can do a Meta regression for high heterogeneity
If you add and minus 1 standard deviation to a normal distribution what percent of the data will you cover?
1 standard deviation = 68%
2 standard deviation = 95%
3 standard deviation = 99%
How to test if you data is normally distributed?
Look to see if curve is bell curved - not finite
Skewness (how the curve leans) should be between -1 and 1
Kurtois = (the peakedness or flatness of a distribution) , Kurtois should be between -1 and 2
Can still go ahead and analyse if values are just outside of boundaries
Is under descriptive statistics in SPSS, you look at the statistic values in the skewness and kurtois
Whats negative and positive skew?
Positive is when most of the results are bellow the middle
Negative skew is when most of the results are past the middle
What’s mesokurtic curve?
Kurtois is normal
What’s a leptokurtic curve?
Very peaked - positive kurtois
Whats a platykurtic curve?
Very flat - negative kurtois
T test definitions?
Test whether there is a difference between 2 means
t-tests are used to test if the difference between the 2 means is likely to be a real difference or one that occurred by chance (sampling variation)
p-value = probability that it occurred by chance
two types of t tests
Independent samples t tests?
Independent groups: Different people in each sample mean
Looks at differences between 2 different groups
Dependent / paired samples t test?
One group the sample people in each sample mean (except twin studies)
Look at differences within the same group in different conditions/ time-points (before/after)
Hypotheses types?
Null hypothesis = states there will be no difference between the groups
The alternative hypothesis = states there will be a difference between groups
Are most t tests 2 directional?
Yes, eg. there will be a significant difference between the lowering of blood pressure from drug a to drug b
Occasionally 1 tailed = Drug A will be better than Drug B, (but if Drug B is actually better than Drug A you cannot report it as that is not what you’ve tested, and this would have important implications on people’s health). If Drug B was a newer, much cheaper drug than Drug A, then the implications would be the same whether Drug B was better or same as Drug A ….. under both circumstances we’d recommend people used Drug B. (non-inferiority study)
What does the P value / significance level have to be below for it to be significant and in a t-test mean that the 2 means are significantly different?
p < 0.05 (expect when applying the Bonferroni correction)
This is when we believe the observed difference hasn’t happened due to random chance (95%)
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Type 1 error:
You reject the null hypothesis - when the null hypothesis is true (you say there is a difference when there isn’t)
Due to random sampling
Type 2 error:
You fail to reject the null hypothesis when the null hypothesis is false (you say there isn’t a difference when there is)
Due to random sampling
Easy way to remember is boy who cried wolf did a type 1 error then a type 2
Assumptions about the data that need to be satisfied for the results of a t-test to be reliable?
Data is continuous and is normally distributed (eg.height weight, strength, glucose)
Both groups are a random sample of a population (if testing whether males are taller than females, don’t take female basketball players and male jockeys)
Homogenity of variance - both groups have similar variances or standard deviations (can visualise this if the distribution curve is far more spread out than the other) - if the assumption is violated in SPSS it offers a an alternative corrected result
Whats a parametric test compared to a non parametric
A parametric statistical test is one that makes assumptions about the parameters (defining properties) of the population distribution(s) from which one’s sample data are drawn (normally distributed continuous data)
- are preferable as provide more reliable and interpretable results, however if sample is small and clearly not normal should use non-parametric tests
Pearsons correlation, independent samples t-test, paired samples t-test, one way ANOVA, Repeated measures ANOVA
A non parametric test is one that makes no such assumptions - used when data is not applicable to a parametric test ie. your sample is small and your data is clearly not normal (ordinal /rank data)
Spearman’s rank order correlation
Mann-Whitney U-test
Wilcoxon signed rank test
Kruskal-Wallis ANOVA
Friedman’s ANOVA
Strength of Evidence with p values?
p > 0.1 no evidence against null
p = 0.05 to 0.1 not quite enough evidence against the null (only relevant if this is the most significant value you got in the whole study
p < 0.05 moderate evidence against null
p < 0.01 strong evidence against the nulll
p < 0.001 very strong evidence against the null
What do ANOVAS do?
Compare 3 or more means
Type of ANOVA depends on:
The number of independent variables, 1 IV = one-way, 2 IVs = two-way and so on
The type of independent variables:
Is it independent samples = groups
Or repeated measures = conditions or time-points
Types of ANOVA?
One way independent sample ANOVA (one independent variable)
Two way independent sample ANOVA (two independent variables)
One way Repeated Measures ANOVA (one independent variable)
Two way Repeated Measures ANOVA (two independent variables)
Two way Mixed Design ANOVA (when you have independent samples and repeated measures) (Two independent variables)
Why not compare several means with lots of t-tests?
Cannot look at several variables simultaneously:
Performing multiple t- tests inflates the type 1 error rate (as for every test have to 0.95^x, with x being the number of tests)
Theory of independent sample ANOVA and how to work out F ratio?
The F-ratio = Between group variance / Within group variance
Between group variance = distance between group means (of the outcome variable) and the overall sample mean. (This is due to differences in the independent variable or experimental manipulation)
Within group variance = Distance between each participant and the mean of the group they belong to
How to find critical values of F for 0.05?
Degrees of Freedom: - how many values do you have to know for you to be able to work out the final value if know the sum of squares
A = For between groups = (Number of groups - 1)
B = Within groups = (Number of people in the study - the number of groups)
So Write out represents (A,B)
Look up in the table Where A and B meet, and this is your critical value, and if F is larger than the value you find in the table, the result is significant
How is the ANOVA an omnibus test?
The F-ratio can only tell us if group means are different
It does not tell us which group means differ from which
We need follow-up / ‘post-hoc’ tests to find out where the group differences ar
Hypothesis in One-way IS-ANOVA?
Null = There are no differences between the group means (mean1 = mean2 = mean3)
Alternative = At least one group mean is different from the other group means (not all means are equal)
Assumptions of IS-ANOVA
Random selection and representative sample
Normal distribution each group
Equal variance in each group (homogeneity) - done by Levene test - if significant homogeneity has not been met
(even if data is not normally distributed and variance is unequal, if sample sizes are large and close to equal, the F in ANOVA is reasonably robust
What is the Sum of Squares?
Distances from the means
Between groups = sum ((mean of group - overall mean)^2) x number of person in each group)
Within groups = Sum((Individual values - mean of group)^2)
Total sum of squares = Sum((individual values - overall mean)^2)
Working out degrees of freedom between groups, within groups and total
A = For between groups = (Number of groups - 1)
B = Within groups = (Number of people in the study - the number of groups)
C = Total = Number of people in study - 1
Example of reporting an IS-Anova?
There is very strong evidence to reject the null hypothesis in favour of the alternative hypothesis. There is a significant difference in the cognitive anxiety of sports men and women depending on the competitive level at which they play (F(3,60) = 14, p<0.001)
When looking cat SPSS output post hoc-tests how do you what is significantly different?
Look through and see what comparisons are significant
Example writing it:
Post Hoc independent t-tests with a Tukey’s correction to the alpha were performed in order to identify where differences in competitive level lay
Results revealed that club level athletes demonstrated significantly higher levels of cognitive anxiety than any of the other three competitive level performers (Club = 16.6, county = 12.2, national = 10.3, international = 9.1 , p <0.01). However Anxiety was not different between County, national and international level performers (all p > 0.05)
Levels in a two-way IS-ANOVA?
2 x 2 = eg. gender (M & F) x Common cold (Y/N) on minutes spent ‘not concentrating in statistics lectures’
2 x 4 eg. breakfast status (Y/N) x hours of sleep (2, 4, 8 , 8) on average power output performance in 30sec Wingate test
3 x 3 = eg. weight status (normal/overweight / obese) x no of cars in house hold (0/1/2+) on how much you exercise
Whats the issue with 2-way IS ANOVA?
Like any ANOVA F-ratio only can tell us not all the group means are not the same so have to do post hoc tests for follow up
However 2 way IS ANOVA is very clunky on follow up tests for sig interaction and very underpowered
What is an interaction?
This is when the effect that one factor has on the outcome variables differs depending on the levels of another factor
Examples:
If one line changes as the other factor does, but the other factor doesn’t shows an interaction
Both main effects significant but not the interaction (lines parallel and sloped with a gap so gender and comp level both effect)
(or parallel and straight = just gender effect)
(or parallel and sloped put lines on top of each other means only comp level is effecting)
How to inexpert main effects when the interaction is significant?
On SPSS see it on the gender*level significance for example (seen on graph from diverging towards or away from each other)
Usually if an interaction is significant we would not interpret the main effects even if they are themselves significant, as will not be true at certain levels
Sometimes can interpret main effects when the interaction is significant
One-way RM-ANOVA?
The levels within the ONE factor represent conditions/time-points measured on the ONE group of people
Each participant provides outcome data for all conditions/time-points of the one factor
Example of a One-way RM-ANOVA?
Each person had glucose and insulin monitored on three dats, each day under a different condition (the orders in which people did these conditions was random)
- Sitting all day (9hrs)
- Sitting all day apart from 2 mins of standing every 30 mins
- Sitting all day apart from 2 mins of walking every 30 mins
What does variance within individuals composed of?
‘Condition variance’ - variance due to the experimental condition (SSc)
‘Error variance’ Variance not explained by the condition (SSe)