-
Clinical Research
Structured process of investing facts and theories and exploring connections
-
Scientific paradigms
ways of looking at the world that define both problems and range of legitimate evidence of contributes to solutions
-
5 Sources of Knowledge
- -Tradition
- -Authority
- -Trail and Error
- -Logical Reasoning
- -Scientific Method
-
Tradition
- -common foundation for communication and interaction within a society or
- profession
- Belief system, inherit knowledge and accept
- precedent w/o external validation
- Problems – not evaluated for validity, tested
- against better alternatives, sole reliance on precedent as reason
-
Authority
-expertise of specialist, specialized training or experience
Use them w/o evidence
Use when evidence is unavailable
- Jeopardize professional responsibilities if not
- scientifically documented
-
Trial and Error
Attempts one solution and evaluates its effect
- -If effects reasonable then adopted
- -If not, another solution is tried
- -No other basis for making a decision
- -Haphazard and unsystematic nature
- -Knowledge obtained usually not shared, making it
- inaccessible to others
-
2 Types of Logical Reasoning
Deductive and Inductive Reasoning
-
Deductive Reasoning
Acceptance of a general proposition or remise and subsequent inferences.
- -Greater the accuracy of premise = greater accuracy of conclusion
- -Produces a testable hypothesis
- -Limitations - dependent on truth of its premise
- -Based on existing knowledge = cannot be source of new knowledge
-
Inductive Reasoning
- Developing generalizations from specific observations
- -Facts gathered on a sample of events could lead to inferences about the whole
- -Limitation - quality based on specific observations
- -Need to observe all possible examples of event
- -Incomplete observations
-
Scientific Method
Incorporating elements of deductions and induction in a systematic and controlled analysis of phenomena
-
Quantitative Research
Measurements of outcomes using numerical data under standardized conditions
-
Qualitative Research
- Deep understanding of phenomenon through narrative description
- -Obtained under less structured conditions
- -Measurements – open ended questions, interviews,
- observations
- -Describe state of conditions or associations,
- formulate theory, or general hypothesis
-
Basic Research
- Obtain empirical data used to develop, refine, or test a theory
- -Acquisition of new knowledge w/o reference
- -“bench research”
- -goal – intellectual curiosity, new knowledge for
- own sake
-
Applied Research
- Immediate practical problems w/ functional applications and testing the theories that direct practice
- -Most clinical research
-
Translational Research
Application of basic scientific findings to clinicaly relevant issues and generating scientific questions based on clinical dilemmas.
-
Experimental Research
- Manipulates and controls one or more variables and observes results on other variables.
- -Purpose: Compare conditions or intervention groups, cause-and-effect relationship
- -Randomized Controlled Trial - "Gold Standard'
-
Non-Experimental (Observational) Research
- Generally more descriptive or exploratory in nature
- -No direct control of variables
-
Exploratory Research
- Examines a phenomenon of interest and explores its dimensions
- -How it relates to other factors
- -Generate relationships and predictions
- -Methodological studies - correlational methods to demonstrate reliability and validity
-
Descriptive Research
Attempts to describe a group of individuals on a set of variables to document their characteristics
-
Systematic Reviews
Comprehensive analysis of full range of literature on a particular topic, intervention, diagnostic test, or prognostic factors
-
Meta-analysis
Statistically combining findings from several studies to obtain a summary analysis
-
Target population
The group of individuals to which the results of the study will apply
-
Research Rationale
- -Will support the research question
- -Guide decisions designing the study
- -Provide basis for interpreting results
-
Factor Variables
Represent a concept, can have more than 1 value
-
Independent Variables
Predictor variables, predict or cause a given outcome
-
Dependent Variables
Outcome variable, response or effect that varies depending on independent variable
-
Operational Definition
Defines a variable according to its unique meaning within a study
-
Specific aims/guiding questions
Describe the study's purpose
-
Hypothesis
A declarative statement that predicts the relationship between the independent and dependent variables and specifying the population that will be studied
-
Deductive Hypothesis
Based on theoretical premise, allowing clinician to predict outsomes
-
Inductive Hypothesis
Based on trends, regularities, patterns, or relationships
-
Research Hypothesis
States researcher's true expectations of results
-
Null Hypothesis
Express no difference or no relationship between ind. and dep. variables
-
Simple Hypothesis
1 ind. and dep. variable
-
Complex Hypothesis
More than 1 ind. or dep. variable
-
Primary Source
- Report or document provided directly by the person who authored it
- -Mostly professional journals
-
Secondary Source
- Description or review of 1 or more studies presented by someone other than the original author.
- -Textbooks, newspapers
- -Tend to provide insufficient, inaccurate, or biased info
-
Continuous varibale
- Theoretically take on any value to represent quantities of characteristics according to certain rules
- -50.5 degrees, 50.3 degrees
-
-
Dichotomous variables
- Assign number to qualitative variables
- -e.g. Gender = Male, Female
-
Precision
Exactness of measure
-
Constructs
- Associated with some value or vales that are assumed to represent original variable
- -Muscular strength- broken down into type of contractions, strain resistance, joint position, etc.
-
Nominal Measurement
- Classifactory scale
- -Categorize subjects e.g., Male = 1, Female =2
-
Ordinal Measurement
- Categorizes by rank ordered on the basis of operationally defined characteristics or property
- -Does not know actual distance between units
-
Interval scale
- Rank order characteristics of ordinal but also demonstrates known and equal distance or intervals between units of measure
- -e.g. no absolute zero
-
Ratio Measurement
Interval scale with absolute zero
-
Reliability
- Extent to which a measurement is consistent and free from error
- -Conceptualized as reproducibility or dependability
-
Validity
Assures that a test is measuring what it is intended to measure
-
Measurement error
The difference between the true value and the observed value
-
Systematic errors
- Predictable errors of measurement
- -Occur in one direction - Over or under estimating
-
Random error
Measurements due to change and can affect a subject's score in an unpredictable way from trial to trial
-
Regression towards the mean
Extremes move closer to mean with more trials
-
Variance
A measure of variability or differences among scores within a sample
-
Reliability coefficient
- 0.0 = no reliability
- 1.0 = perfect reliability
-
Test-retest reliability
- Establish that an instrument is capable of measuring a variable with consistency
- -e.g. Identical test on two separate occasions
-
Rater Reliability
Human observer/rater part of the measurement system
-
Intrarater reliability
Stability of data recorded by one individual across two or more trials
-
Interrater Reliability
Variation between two or more raters who measure the same group of subjects
-
Alternative form reliability
Alternative to test-retest reliability
-
Inernal Consistency (homogeneity)
Extent to which items measure various aspects of the same characterisitcs and nothing else
-
Generalizability theory
- Results define the universe
- -Testing condtions must be the same
-
Facet
Relation to a set of specific testing conditions
-
Minimal Detectable Difference (MDD)
Define the amount of change in a variable that must be achieved to reflect a true difference
-
Population Specific Reliability
Reliability established on subjects from one population cannot automatically be attributed to other populations
-
Measurement validity
Instrument measures what it is intended to measure
-
Specificity of validity
Instrument is appropriate for the test (measures item of interest)
-
Face Validity
The instrument appears to test what it is supposed to and plausible method
-
Content Validity
- Adequacy with which this universe is sampled by a test
- -Does not contain all the elements that reflect the variable being studied
- -Free of influences of factors irrelevant to purpose of study
-
Criterion-related Validity
- Most practical and objective approach
- -e.g. Investigate HR (target test) as indicatry O2 consumption (criterion measure)
-
Concurrent measure
- Measurement to be validated and criterion measure taken relatively same time
- -Both reflect same score
- -Useful for testing new/untested tools
-
Predictive measure
Establish a measure that's valid predictor of futur criterion score
-
Construct Validity
- Ability of instrument to measure an abstract concept
- -Convergent: 2 measures on the same phenomenon will have similar test results
- -Discriminant: 2 measures on the same phenomenon will have different results
- -Factor Analysis: construct contains 1 or more underlying dimensions or different theoretical components
-
Change/different score
- Difference between outcome and initial scores
- -Shows/demonstrates change
-
Minimal Clinically Important Difference (MCID)
the lowest amount that can be considered change
-
Criterion-referenced test
- Fixed standard that represents acceptable model or level of performance
- -Examine proficiency or performance of skill
- -Norm-referenced - "Normal" values determined by testing large populations of certain profiles
- -Standard deviation
- -Establish placement for diagnosis
-
Cross-validation
Trying out previously developed test on a new group of characteristics as close as possible to original
|
|