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PHC215
By Dr. Khaled Ouanes Ph.D.
E-mail: [email protected]
Twitter: @khaled_ouanes
INTRODUCTION TO
HEALTHCARE RESEARCH
METHODS
Focusing on the Research
Question
Primary, Secondary, and Tertiary
Research
Key Considerations
Study Goals & Specific Objectives
The literature review and consideration of a study
approach should lead to the selection of one very
specific study topic that can be stated in terms of a
single overarching study goal or study question.
A study goal often includes the specific exposure,
disease, and population that will be the focus of the
study
Examples of Study Goals
After finalizing the overarching study goal, the researcher
should identify three or more specific objectives (also
called specific aims or specific hypotheses) that stem from
the main study goal.
Each of these specific objectives should take the form of
a measurable question or a “to” statement.
Each should represent a logical step toward answering
the main study question.
Example
Study goal: “to assess the impact of lead
poisoning on school performance in
kindergarten students in USA.”
Specific objective #1:
1. To measure the prevalence of high blood lead levels in a
random sample of kindergarten students in USA.
Example
Study goal: “to assess the impact of lead
poisoning on school performance in
kindergarten students in USA.”
Specific objective #2:
2. To determine whether children in that sample with high
blood lead levels have lower scores on academic tests
than children with lower blood lead levels.
Example
Study goal: “to assess the impact of lead
poisoning on school performance in
kindergarten students in USA.”
Specific objective #3:
3. To estimate the total impact of high blood lead levels on
kindergarten performance in USA by applying the rates in
the sample population to the total population of the
region / Country.
Example
Note that all three of these
specific objectives relate to the
overall study goal and provide a
clear pathway for achieving the
main goal.
ESSENTIAL QUESTIONS TO THE
SUCCESS OF THE PROJECT
ESSENTIAL QUESTIONS TO THE
SUCCESS OF THE PROJECT
Assembling a Support
Team
Research projects benefit from the
input of technical and cultural experts.
A team of collaborators should be
assembled early in the research
process.
Members of the Team
Although some papers in the health
sciences have solo authors, most
papers have about four coauthors,
and some have dozens of coauthors.
All of what we have seen until now in the
previous presentations is about the 1st step:
Identifying a Study Question
Selecting a Study
Approach
The 2nd step: Selecting a Study Approach
Overview
The 2nd step in the research process is to select a general study approach.
This section provides an overview of 8 common study designs.
1. Reviews / meta-analyses
2. Correlational (ecological)
studies
3. Case series
4. Cross-sectional surveys
5. Case control studies
6. Cohort studies
7. Experimental studies
8. Qualitative studies
The Studies Approaches
Prim
ary
, Se
co
nd
ary
,
an
d Te
rtiary
Stu
dy
Ap
pro
ac
he
s
Study duration
Primary Studies:
Study duration
Secondary & Tertiary Studies:
The study duration is dependent on how existing data & articles will be acquired.
Population Selection for Each
Study Approach
REVIEWS
A review article or meta-analysis carefully gathersall prior publications on a specific topic andsummarizes them to provide a big-pictureanalysis.
Meta: meaning "after", or "beyond") is a prefix used inEnglish to indicate a concept which is an abstraction from
another concept, used to complete or add to the latter.
The required Steps:
1. An extensive search of the literature
2. Extraction of key information from relevant
articles
3. Clear and concise presentation of this
information
The benefits:
A literature review is an effective way to become an
expert in the literature on a well-defined topic
A literature review is a helpful step in preparing for future
primary or secondary analyses
Review articles are often cited more often than reports
of individual field studies
The limitations and drawbacks:
Not all journals publish review articles (especially reviews
that the editors do not solicit)
Reviews are sometimes perceived to be a less rigorous
form of research than projects that collect new data
and/or involve statistical analysis
Selecting a Topic
The most important decision is to select a topic
that is narrow enough that all the relevant
publications can be acquired.
The topic may need to be modified after a
preliminary search, depending on the number of
articles available.Example:
9 = too few expand the scope
100+ = too many narrow the scope
Library Access
The full text of every relevant article must be identified and obtained.
Check with a university librarian about the library’s policies and the fees that may be charged for the use of interlibrary loan services.
Maintain a meticulous system for tracking articles that have already been acquired, those that have been requested but not yet received, and those that need to be requested.
Narrative Reviews
Narrative reviews tell a “story” about a well-
defined topic using evidence from the literature
to support the “plot”
Narrative reviews must be carefully organized
by theme, methodology, chronology, or some
other guiding principle
The absence of a systematic search strategy
must be justified by the researcher
Systematic Reviews
Systematic reviews are designed to minimize the bias that might occur when review article authors handpick the articles they want to highlight
After the identification of the study question, the most important decision in a systematic review is the selection of keywords and inclusion criteria
The goal is to craft a search strategy that identifies all the articles ever published on the narrow, well-defined area covered by the review
Once the articles are identified from one or more abstract databases, each article is screened to see whether it is eligible for inclusion.
Relevant information is extracted from all eligible articles and presented in table form.
Then the trends and key observations are summarized.
Systematic Reviews
Sy
stem
atic
Re
vie
ws
Meta-Analysis
The goal of a meta-analysis is to combine the results of several high-quality articles that used similar methods to collect and analyze data into one summary statistic.
Meta-analysis usually begins with a comprehensive systematic review of the literature to identify every single possibly relevant article.
The steps of a meta-analysis are to:
Conduct a systematic review
Assess the quality and comparability of each eligible study
Extract statistical results from each study that meets all
inclusion criteria
Combine these statistical results into one summary statistic
Meta-Analysis
Key Characteristics of Reviews and Meta-
Analyses
Key
Characteristics
of Reviews and
Meta-Analyses
PHC215
By Dr. Khaled Ouanes Ph.D.
E-mail: [email protected]
Twitter: @khaled_ouanes
HEALTHCARE RESEARCH METHODS
Based on the textbook of introduction to health research methods – K.H. Jacobsen