spectrumofresearch.txt

• Descriptive - simply describing a group of individuals about a set of variables - no comparison or manipulation of variables
• Exploratory - exploring a phenomenon and how it causes two variables to relate to one another (IE trying to find correlation)
• Experimental - controlling and manipulating groups in order to eradicate extraneous variables and come to a conclusion about cause and effect

Typically have quantitative data, are normative, observational studies and case reports

• Look for relationships between variables
• Statistics
• Correlation
• Regression
• Risk Estimate
• Do not manipulate variables
• No assignment to groups
• No control

• Group assignment
• Control
• Manipulation of Variables
• CAUSE and EFFECT

• -Systematic Review of Multiple RTCs
• -Randomized Controlled Trial
• -Experimental Trials without randomization or control
• -Non Experimental Studies
• -Respected Opinions

Levels 3 through 6 are changed to cohort studies and case control studies, case series and case reports, opinions and letters, animal research

• screen the article
• assess methodological quality
• assess the clinical relevance of results

Was the study original? Is there a reasonable focused research question?

• Examine methods and results
• Assure authors conclusions are trustworthy - limit bias, data to support conclusions, appropriate methods, appropriate analyses

• Control group
• Blinding of assessors, subjects, practitioners
• Group assignment
• Drop outs
• Sample Size
• Statistical analyses
• Baseline characteristics
• ETC!!!!!

Statements that help with decisions on specific conditions. Can change practice/outcomes.

• Help individuals receive effective (and cost-effective) services
• Help identify individual needs
• Help train professionals
• Facilitate productive communication between professionals
• Facilitate quality improvement
• Indicate where more research is needed
• Uses a scientific process that is evidence-based
• Ensuring multidisciplinary approach
• Developing a guideline that is valid, objective and credible
• Each guideline recommendation is given a “strength of evidence” rating
• Indicates the amount, general quality, and clinical applicability of scientific evidence

• I. Strong evidence from at least one systematic review of multiple well-designed RCTs (systematic review is more than a lit review uses explicit methods to identify, select and critically appraise relevant research)
• II. Strong evidence from at least one properly designed RCT of appropriate Size (often this is inappropriate or unethical in clinical research)
• III. Evidence from well designed trials without randomization, single group pre-post, cohort, time series or matched case controlled studies
• IV. Evidence from well-designed non-experimental studies from more than one research group
• V. Opinions of respected authorities, based on clinical evidence, descriptive studies or reports of expert committees - useful but these are biased by the experience and values of those involved and should therefore be treated cautiously, although in many areas they are currently the best available evidence

• Level of rigor to reviewing research evidence = rigor in production of research
• Find all relevant studies
• Synthesize the findings from individual studies in an unbiased way
• Present a balanced and impartial summary
• Available in journals and electronically

• Be careful...
• May not have been done well
• Inappropriate aggregation of studies
• Drowning of important effects
• Not always consistent with the large high quality study

• Is the topic well defined?
• Intervention
• Population
• Outcome
• Was the search for papers thorough?
• Search strategy described
• Non-English
• “grey” literature covered
• Criteria for inclusion of studies
• Assessment of study quality
• Missing information
• Similar effects in the studies
• Overall findings assessed for robustness?
• Probabilities examined?
• Recommendations based firmly on quality of evidence?