2. Methods and Evidence

Question 1

What are the two main groups of methods for investigating health and illness?

Answer 1

Quantitative and qualitative.

Question 2

What is quantitative research?

Answer 2

A collection of numerical data which begins as a hypothesis.

Question 3

What are the strengths of quantitative research?

Answer 3

Reliability and repeatability.

Question 4

What are quantitative research methods good for?

Answer 4

Describing, measuring, finding relationships between things, and allowing comparisons.

Question 5

What are the problems with quantitative research?

Answer 5

May force people into inappropriate categories, don’t allow people to express things in a way they want, may not access all important information, may not be effective in establishing causality.

Question 6

What are some experimental study designs of quantitative research?

Answer 6

RCT, cohort studies, case control studies, cross-setional surveys.

Question 7

How can quantitative research methods be used with secondary analysis of data?

Answer 7

Official statistics from census, national surveys from charities, local and regional surveys from universities.

Question 8

What is a common method for quantitative research collection?

Answer 8

Questionnaires.

Question 9

What can questionnaires provide data on?

Answer 9

Exposure to risk factors, knowledge and attitudes, and satisfaction with health services.

Question 10

What are the two key features that a questionnaire must be?

Answer 10

Valid and reliable.

Question 11

What does validity mean in questionnaires?

Answer 11

Measure what they’re supposed to measure.

Question 12

What does reliability mean in questionnaires?

Answer 12

Measure things consistently so differences are from the participants and not from understanding questions or interpreting responses incorrectly.

Question 13

What is the difference between published and unpublished questionnaires?

Answer 13

Published ones may have been tested for validity and reliability whereas these are yet to be established in unpublished questionnaires.

Question 14

What are the types of questions on questionnaires?

Answer 14

Mainly closed questions - yes/no. Some may have open questions at the end.

Question 15

What is qualitative research useful for?

Answer 15

Understanding the perspective of those in a situation, accessing information not revealed by quantitative research, explaining relationships.

Question 16

What are the limitations of qualitative research?

Answer 16

Not good at establishing relationships, generalisability so may be good at identifying a range of views but can’t extrapolate results to whole population from small sample.

Question 17

What are four designs of qualitative research?

Answer 17

Ethnography/observation, interviews, focus groups, and documentary/media analysis.

Question 18

How is ethnography/observation qualitative research done?

Answer 18

Observe what people do rather than relying on what they say they do. By participant observation (covert) or non-participant observation (overt) - labour intensive but valuable.

Question 19

How are interviews for qualitative research run?

Answer 19

Semi-structured so there is a prompt guide and an agenda of topics but it’s conversational.

Question 20

How are focus groups run to collect qualitative data?

Answer 20

Flexible method to establish parameters in groups.

Question 21

What are some of the limitations of using focus groups in qualitative research?

Answer 21

Not so useful for individual experience, some topics may be too sensitive, hard to arrange.

Question 22

How is documentary/media analysis used in qualitative research?

Answer 22

Independent evidence may provide historical context. Can use television, newspaper, and media stories.

Question 23

What is evidence-based practice?

Answer 23

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

Question 24

What is the main principal of evidence-based practice?

Answer 24

That healthcare should be based on the best available evidence of effectiveness and cost-effectiveness.

Question 25

Before evidence-based practice, what was practice influenced by?

Answer 25

Professional opinion, clinical fashion, historical practice and precedent, and organisations and social culture.

Question 26

What is the Cochrane library a register of?

Answer 26

All RCTs to help evidence-based practice.

Question 27

Why is systematic research done?

Answer 27

Traditional literature reviews may be biased/subjective, addresses clinical uncertainty and highlights gaps in research, offers up to date conclusions, saves clinicians from having to appraise studies themselves, reduce delay between discovery and implementation.

Question 28

What are some practical criticisms of evidence-based practice?

Answer 28

Impossible to have systematic review for all specialities, expensive to distribute findings, RCTs aren't always feasible/desirable, interventions limited to ones that have biomedical outcomes, relies on the good faith of pharmaceutical companies.

Question 29

What are some philosophical criticisms of evidence-based practice?

Answer 29

Population-level outcomes may not apply to an individual, makes professionals unreflective rule follows, lacks professional responsibility/autonomy, legitimises rationing.

Question 30

What are some of the difficulties in getting evidence into practice?

Answer 30

Resources not available to implement change, doctors don't know about the evidence, doctors don't use evidence they know, organisational systems don'ts support innovation, commissioning decisions reflect different priorities.