Session 2 - Methods and evidence Flashcards
What are the two main methods of answering questions about social life?
Quantitative and qualitative research
What is quantative research?
Quantitative research is a collection of numerical data, which begins as a hypothesis
How are conclusions drawn in quantitative research?
By deduction
What are the two main strengths of qualitative research?
Reliability and repeatability
What are the four main things quantative methods are good at?
Describing
Measuring
Finding relationships between things
Allowing comparisons
What are four main problems with quantitative methods?
o May force people into inappropriate categories
o Don’t allow people to express things in the way they want
o May not access all important information
o May not be effective in establishing causality
What are the four main study designs for quantitative research?
RCT
Cohort studies
Case control studies
Cross-sectional surveys
Give three secondary sources which can be quantitatively analysed to give answers
Official Statistics
o Census
National Surveys
o Conducted by e.g. charities, universities
Local and regional surveys
o Conducted by e.g. NHS organisations, universities, local councils
What is one of the most common methods of carrying out quantitative research?
Questionarre
what are the two most important features of a questionnaire design ?
Has to be VALID
Has to be RELIABLE
What does valid mean?
Measure what they’re supposed to measure
Define reliable
Measure things consistently
Differences in results come from differences between participants, not from differences between understanding of questionairres or interpretation of responses
Give two types of questions which can be asked in questionairre?
Closed questions
Open questions
insert picture one
insert picture 2
What are the three main things qualitative methods are good at?
o Understanding the perspective of those in a situation
o Accessing information not revealed by quantitative approaches
o Explaining relationships between variables
E.g. why and how does ethnicity promote/discourage smoking cessation
What are the two main problems with qualitative methods?
o Not good at finding consistent relationships between variables
o Generalisability
May be good at identifying a range of views on an issue, but dangerous to infer these views from a small sample may apply to the population as a whole
Give four different types of qualitative research design
Ethnography and obesrvation
Interviews
Focus Groups
Documentary and Media Analysis
What is ethnography?
Studying behaviour in its natural context
What occurs in ethnography research
o Observe what people actually do, rather than relying on them telling you what they do
o Participant observation – usually covert
o Non-participant observation – overt
Labour intensive but provides valuable insight into what actually happens
Commonly combined with more formal interviews and other sources of data in ethnographic studies
Give four features of interviews
Prompt guide
Clear agenda of topics
Conversational
Emphasis on participants giving their perspective
Give two positives of focus groups
Flexible method
May encourage people to participate
Give four negatives of focus groups
Not useful for individual experience
Some topics may be too sensitive
Difficult to arrange
What specific factors are required for the success of a focus group, in terms of the members of the group
Need a fairly homogenous group, and a good facilitator to manage group dynamics
What is documentary evidence?
Independent evidence - Medical records/patients
Television, newspapers and media stories
What is evidence-based practice?
the integration of individual clinical expertise with the best available external clinical evidence from systematic research.
What are the two main factors taken into account in evidence based practice?
Effectiveness
Cost-effectiveness
What were healthcare decisions in the past influenced by?
o Professional opinion
o Clinical fashion
o Historical practice and precedent
o Organisations and social culture
Why is systematic research important? 6
][
o Traditional literature reviews may be biased and subjective
o Can address clinical uncertainty and highlight gaps or poor quality in research
Critical appraisal tool to assess quality of evidence
o Offers authoritative, generalisable and up to date conclusions
o Save clinicians from having to locate and appraise the studies for themselves
o May reduce delay between research discoveries and implementation
Give five practical criticisms of evidence based practice
o May be impossible to create and maintain systematic reviews across all specialities
o Challenging and expensive to distribute and implement findings
o RCTs seen as the gold standard, but not always feasible or desirable (ethics)
o Choice of outcomes very biomedical, limiting which interventions are trialled and therefore funded (e.g. NICE Guidance)
o Requires ‘good faith’ from pharmaceutical companies
Give four philosophical criticisms of evidence-based practice
o Population-level outcomes may not apply to an individual
o Evidence-Based Medicine may make professionals ‘unreflective rule followers’
o Professional responsibility/autonomy
o Might be seen as a means of legitimising rationing, with potential to undermine trust in the doctor-patient relationship and ultimately the NHS.
Give five difficulties in getting evidence into practice?
o Resources not available to implement change
Financial or human
Evidence exists, but doctors don’t know about it
Distribution of the evidence ineffective?
Doctors not incentivised to keep up-to-date
o Doctors know about evidence but don’t use it
Habit / Organisational culture / Professional judgement
o Organisational systems cannot support innovation
E.g. Managers lack the authority to invoke changes
o Commissioning decisions reflect different priorities
What if patients say they want
something else?
