Exam one: evidence based research
components of PICO
P: population I: intervention/influence C: comparison O: outcome
results section of a research article (qualitative)
findings are often organized according to major themes, processes, or categories identified in the analysis -indicates raw data
positivism (scientific method)
gathering of empirical evidence information is numeric from formal measurement and is statistically analyzed
independent vs dependent
independent= the presumed cause dependent= presumed effect (outcome variable)
journal articles
papers often subjected to peer review
Quantitative Research
positivist tradition
sources of best research evidence
primary studies systemic review -meta-analysis (quant) -meta-synthesis (qual) -meta-aggregation (qual) -mixed studied review (both)
Title of journal article
qual: central phenomenon and group under investigation quant: key variables and the population (PICO)
the lived experience of adult victims of abuse
qualitative
level VII evidence
qualitative study/descriptive study
"Correlations among Social Support, Depression and Anxiety in Patients with Type 2 Diabetes"
quantitative
features in both positivism and constructivism
ultimate goals external evidence reliance on human cooperation ethical constraints fallibility (errors)
Evidence Hierarchy
systematic reviews randomized controlled trials cohort studies case-control studies case series, case reports editorials, expert opinion
level IIV evidence
systemic review of nonexperimental/observational studies
level VI evidence
systemic review/meta synthesis of qualitative studies
constructivist scientific method
understanding the human experience as it is lived dynamic, holistic, and individual aspects of humans flexible; in-depth; can clarify dimensions of complicated phenomenon
blinding / masking
used in some quantitative studies to prevent biases stemming from people's awareness involves concealing info from participants, data collectors, or care providers to enhance objectivity ex. placebo
content of research journal articles
*title and abstract I-introduction M-method R-results A-& D-discussion *references
Components of a Problem Statement
- Identification of the problem - Background - Scope - Consequences - Knowledge gaps - Proposed solution
clinical question
-broad enough to include central concerns -narrow enough to serve as a guide for study design
Introduction of a journal article
-description of central phenomena, concepts, or variables -study purpose, research questions, hypotheses -review of literature -theoretical/conceptual framework -study significance
The method section of a research article (qualitative)
-discuss same issues as quantitative but with different emphases -more info on the research setting and context of study -describe researchers' efforts to enhance integrity of study
results section of a research article (quantitative)
-names of statistical tests -value of statistic -statistical significance (P value)
informed consent
-participants have adequate information -subjects can comprehend -can participate/withdraw
Positivism Paradigm
-reality exists independent of human observation & should be studied and known -nature is regular and ordered -determinism
constructivist paradigm
-reality is a construction of people participating in research -reality exists within a context and is multiple and subjective -reality exists independent of human observation -knowledge is maximized when the distance between the inquirer and participants in the study is MINIMIZED (the subjects voices are crucial)
The method section of a research article (quantitative)
-research design -sampling plan -methods of measuring variables and collecting data -study procedures -analytic methods and procedures
Level II evidence
A well-designed randomized control trial
Ethical Principles
Beneficence dignity justice
statement of purpose: quantitative
Identifies key study variables Identifies possible relationships among variables Indicates the population of interest Suggests, through use of verbs, the nature of the inquiry
statement of purpose: qualitative
Identifies the central phenomenon Suggests the research tradition (e.g., grounded theory, ethnography) Indicates the group, community, or setting of interest Suggests, through use of verbs, the nature of the inquiry (e.g., to describe..., to discover..., to explore...)
primary study
In a systematic review, an original study whose findings are used as the data in the review (new data)
level III evidence
Quasi-experimental studies or nonrandomized trial
nonexperimental research
Researchers collect data without intervening or introducing treatments. -observational studies
Purpose of IRB (Institutional Review Board)
Reviews potential research projects for fairness/potential risks vs. benefits to subjects
level I evidence
Systematic reviews, meta-analyses, randomized controlled trials
p value
The probability level which forms basis for deciding if results are statistically significant (not due to chance).
Respect for human dignity
The right to self determination, the right to full disclosure -right to ask questions/not answer/drop out -right to know potential risks and benefits
meta-analysis
a procedure for statistically combining the results of many different research studies
null hypothesis
a statement or idea that can be falsified, or proved wrong
statistical significance
a statistical statement of how likely it is that an obtained result occurred by chance
concepts
abstractions of particular aspects of human behavior or characteristics (ex. pain) in quantitative studies
phenomena
abstracts in qualitative studies
abstract
brief description of major features of a study at the beginning of a journal article
vulnerable populations
cognitively impaired, pregnant, children, prisoners
Qualitative Research
constructivist tradition
bias
distortion of influence that results in an error in inference
EBP - best evidence
empirical evidence from randomized controlled trials; evidence from other scientific methods such as descriptive and qualitative research; as well as use of information from case reports, scientific principles, and expert opinion.
discussion section of a research journal
interpretation of results clinical and research implications study limitations and ramifications for the believability of the results
Theories
knit concepts into a coherent system that claim to explain some aspect of reality
EBP: Clinical Expertise
knowledge gained during training and continuing education, experiences with patient care, and interdisciplinary sharing of new knowledge
factors leading to bias
lack of participant's candor (honesty) faulty methods of data collection researchers' preconceptions participants' awareness of being studied faulty study design
which section would "the study consisted o 135 mother-infant dyads from an inner-city neighborhood" be found?
method section
beneficence
minimize harm; maximize benefits right to protection from exploitation -participants not placed at disadvantage
level VIII evidence
non-research source ex. expert opinion
level V evidence
nonexperimental/observational study
raw data
quotes directly from study participants
Evidence Hierarchy definition
ranked evidence sources in terms of their risk of bias (least biased or level 1 evidence at the top)
EBP - patient preferences
require understanding patients' circumstances, such as the resource at their disposal
research vs null hypothesis
research: states the actual prediction of a relationship Null: expresses the absence of a relationship
experimental research
researchers actively introduce an intervention or treatment most often to address therapy questions -clinical trials; test casual relationships
justice
right to fair treatment and right to privacy -confidentiality and equal distribution
empirical evidence
rooted in objective reality and gathered through the senses rather than personal belief
Conceptual definition
the abstract or theoretical meaning of a concept being studied
determinisim
the belief that phenomena are not haphazard but rather have antecedent causes -research is to understand the underlying causes and to be unbiased as possible
operational definition
the operations a researcher must perform to measure the concept and collect the desired information
EBP purpose
therapy/intervention diagnosis/assessment prognosis etiology description meaning and process