Session 2 - Methods and evidence

Question 1

What are the two main methods of answering questions about social life?

Answer 1

Quantitative and qualitative research

Question 2

What is quantative research?

Answer 2

Quantitative research is a collection of numerical data, which begins as a hypothesis

Question 3

How are conclusions drawn in quantitative research?

Answer 3

By deduction

Question 4

What are the two main strengths of qualitative research?

Answer 4

Reliability and repeatability

Question 5

What are the four main things quantative methods are good at?

Answer 5

Describing
Measuring
Finding relationships between things
Allowing comparisons

Question 6

What are four main problems with quantitative methods?

Answer 6

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

Question 7

What are the four main study designs for quantitative research?

Answer 7

RCT
Cohort studies
Case control studies
Cross-sectional surveys

Question 8

Give three secondary sources which can be quantitatively analysed to give answers

Answer 8

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

Question 9

What is one of the most common methods of carrying out quantitative research?

Answer 9

Questionarre

Question 10

what are the two most important features of a questionnaire design ?

Answer 10

Has to be VALID

Has to be RELIABLE

Question 11

What does valid mean?

Answer 11

Measure what they’re supposed to measure

Question 12

Define reliable

Answer 12

Measure things consistently
Differences in results come from differences between participants, not from differences between understanding of questionairres or interpretation of responses

Question 13

Give two types of questions which can be asked in questionairre?

Answer 13

Closed questions

Open questions

Question 14

insert picture one

Answer 14

insert picture 2

Question 15

What are the three main things qualitative methods are good at?

Answer 15

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

Question 16

What are the two main problems with qualitative methods?

Answer 16

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

Question 17

Give four different types of qualitative research design

Answer 17

Ethnography and obesrvation
Interviews
Focus Groups
Documentary and Media Analysis

Question 18

What is ethnography?

Answer 18

Studying behaviour in its natural context

Question 19

What occurs in ethnography research

Answer 19

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

Question 20

Give four features of interviews

Answer 20

 Prompt guide
 Clear agenda of topics
 Conversational
 Emphasis on participants giving their perspective

Question 21

Give two positives of focus groups

Answer 21

Flexible method

May encourage people to participate

Question 22

Give four negatives of focus groups

Answer 22

Not useful for individual experience
Some topics may be too sensitive
Difficult to arrange

Question 23

What specific factors are required for the success of a focus group, in terms of the members of the group

Answer 23

Need a fairly homogenous group, and a good facilitator to manage group dynamics

Question 24

What is documentary evidence?

Answer 24

Independent evidence - Medical records/patients

Television, newspapers and media stories

Question 25

What is evidence-based practice?

Answer 25

the integration of individual clinical expertise with the best available external clinical evidence from systematic research.

Question 26

What are the two main factors taken into account in evidence based practice?

Answer 26

Effectiveness

Cost-effectiveness

Question 27

What were healthcare decisions in the past influenced by?

Answer 27

o Professional opinion
o Clinical fashion
o Historical practice and precedent
o Organisations and social culture

Question 28

Why is systematic research important? 6

Answer 28

][
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

Question 29

Give five practical criticisms of evidence based practice

Answer 29

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

Question 30

Give four philosophical criticisms of evidence-based practice

Answer 30

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.

Question 31

Give five difficulties in getting evidence into practice?

Answer 31

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?