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Research 1

Research 1. By Dr. Michael Green & Emily Pollock Adapted from: T he Five Weekend Course on Answering a Research Question in Primary Care – Godwin and Rosser, CSPC & Charting Pathways to Discovery, Bracken Health Sciences Library, Queen’s university. Objectives. Types of projects

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Research 1

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  1. Research 1 By Dr. Michael Green & Emily Pollock Adapted from: The Five Weekend Course on Answering a Research Question in Primary Care – Godwin and Rosser, CSPC & Charting Pathways to Discovery, Bracken Health Sciences Library, Queen’s university

  2. Objectives • Types of projects • Steps to developing a research question • How to do a good literature search • How do critically appraise a paper

  3. Types of Projects • Systematic Review – formal evidence-based review requiring defined criteria for inclusion/exclusion of studies to minimize bias and systematic error, it may also include a meta analysis (integration of numerical data from more than 1 study) • Critical Appraisal – four to six key articles on a topic, reviewed critically in detail • Original Research – develop a hypothesis, detailed methodology and include analysis • Advocacy Project – work with a community group to develop and/or evaluate a program/resource (must include a literature search and evaluation or reflective narrative) • Information Technology – a program or tool to support or enhance the medical institution (must include a literature search) • Ethics Project – a scholarly paper that identifies and analyzes an ethical issue in Primary Care

  4. Developing a Question • Choose a topic • Identify a problem • Ask a question • Refine and define

  5. Choose a Topic Feasible (manageable in size, has obtainable data, within your range of competence) Interesting (sustains your interest, and is of interest to others in primary care) Novel (has potential to make an original contribution) Ethical (do you need REB approval?) Relevant (be worth solving) • An example topic may be “Cardiovascular risk reduction” or it could be broader such as “Cardiovascular disease”

  6. Identifying a Problem • Identify an issue or component of the topic where there is a need for research • An example of a problem might be: “There has been a marked increase in the prevalence of obesity in children and adolescence over the past 10-20 year.”

  7. Asking a Question • What exactly do you want to find out? What is it that you don’t know that will help you address/resolve the problem? • A good research question is: • Well defined and focuses on specifics • Quite concrete and should actually tell others what it is that you are looking at in particular • Should be about 1 of 4 things: • 1) To obtain a better description of the problem (i.e. what proportion of children are obese?) • 2) To determine relationships within the problem (i.e. Are children from higher socioeconomic backgrounds more likely to be obese?), • 3) To determine means to solve a problem (i.e. Will a program of healthy lifestyle change introduced into the school system prevent the development of obesity?), • 4) To understand the problem better (i.e. What is it like to be an obese teenager?)

  8. PICO Question Model Patient or population Intervention Comparison Outcome • PICO & other framing structures http://library.queensu.ca/health/guides/researchquestions

  9. Refining and Defining • The most important step • Best to do this after you’ve done some initial research • Break down each section of the question to see if you have defined everything or if it still lacks clarity: • What is the population? • How is the population selected (age, sex, experience etc.)? • What is the intervention? • What outcome do I expect? • How is the outcome measured? • More information here

  10. Refining and Defining For example, refining the question: “Will a program of healthy lifestyle change introduced into the school system prevent the development of obesity?” • What is the population? • Will a school program of healthy lifestyle change for students in grades 4-6 decrease the incidence of obesity in those same students in Grade 12? • What is the program of healthy life style? & What will the program be compared to? • Are Grade 12 students who received the Triple E program when they were in grades 4-6 less likely to be obese then Grade 12 students who attended a public school where the program was not available? • What is obesity? • Are Grade 12 students who received the Triple E program when they were in grades 4-6 less likely to have a BMI of 30 or greater then Grade 12 students who attended a public school where the program was not available? • Questions can also be stated as a hypothesis • Grade 12 students who received the Triple E program when they were in grades 4-6 are less likely to have a BMI of 30 or greater than Grade 12 students who attended a public school where the program was not available.

  11. Literature Search • For more information visit DFMQueens • Data bases: • MEDLINE – Ovid/Pubmed • EMBASE – European version of MEDLINE, great for drug questions • EBM – Evidence based medicine, systematic reviews, clinical trials • PsychInfo– Psychiatry/Psychology questions • AMED – Allied & complementary medicine • Global Health – Developing world/underserviced populations • CINAHL – Allied health, physical/occupational therapy, nursing, exercise, health promotion • ERIC – Education

  12. Search Strategy • Break your topic up into discrete concepts (2-3 major concepts) • E.g. Prevention of lower extremity injuries in long-distance runners – Rod MacNeil, Primary Care Research Day 2014

  13. Search Terms • Keyword – a particular term in the title, abstract or author’s name • Subject – only 1 term needs to be found to capture a concept • In Medline, the subject “runner” finds the following terms: running, adult, physical endurance, middle aged, oxygen consumption, exercise, liver, zinc, tibia, osteoporosis • In Medline, subjects are termed MeSH terms (Medical Subject headings)

  14. Search Terms • Combine terms using AND or OR • AND – narrows your search by finding records that contain all terms entered • OR – broadens your search by finding records that contain either or all terms entered • Truncation can be used for variant terms • educat$ = education, educator, educates…

  15. Systematic process to evaluate the strengths/weaknesses of a research paper & to evaluate the usefulness and validity of the findings • Questions to answer: • Is the study question relevant? (Subjective to one’s own field of work) • Does the study add anything new? • What type of research question does the study pose? ( a well developed question usually identifies: population, study parameter, outcomes) • Was the design appropriate for the question? • Did the methods address potential sources of bias? • Does the study test a stated hypothesis? • Were statistical analyses performed correctly? • Do the data justify the conclusions? • Are there any conflicts of interest?

  16. Study Selection • # of potentially relevant citations from the literature search • # in MEDLINE • # in EMBASE # of Citations excluded; not relevant # of Abstracts reviewed • # of Citations excluded base on • Inclusion/exclusion criteria: • e.g. • # conducted before 2010 • # used male participants # of Studies included in this review

  17. GAP Work • Between Research 1 and Research 2: • study the literature to determine who has previously tried to answer your question and describe what we already know about the answer

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