Sealing wax and bits of string - good outputs from limited inputs

1. Sealing wax and bits of string- good outputs from limited inputs Professor Colin P. Bradley Professor of General Practice University College Cork

4. Half full or half empty? Two ways of looking at research in Irish general practice/ primary care • We have very few resources so we can do very little • We can be ingenious with our meagre resources and do quite a lot

6. Some examples of ingenious use of limited resources • Epidemiology in Country Practice – Pickles, 1939 • The Medical Life History of Families – Huygen, 1978 • Clinical judgement and antibiotic prescribing – Howie, 1976 • The consultation and the therapeutic illusion – Thomas, 1978 • The B-score – Dobbs 1996

7. Small studies can have a bit impact • Goffman’s ‘Assylums’ • McBride – letter to Lancet highlighting thalidomide disaster • Significant event analysis study • Uncomfortable prescribing study

9. Strategies for managing limited resources • Keep the study small • Limiting ambition • Pilot and exploratory studies • Hypothesis generation studies - qualitative • Transfer of setting studies – concept proven elsewhere, does it work here? • Using non-research resources for research purposes • Collaboration – other practices, settings, researchers – international collaborations • Secondary research e.g. systematic reviews

10. Some take home messages • You must cut your coat to suit your cloth • Studies have to be scaled to answer the questions they pose (power calculations) • Try to develop questions of a size you can answer • Be original • Be rigorous/ thorough • Do the best research you can with whatever resources you have • Qualitative research is a good option but not a complete solution