Research Definitions, Types, Problems and Objectives
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Transcript of Research Definitions, Types, Problems and Objectives
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Research Methodologyfor MSc Students
Berihun Megabiaw (MD,MPH)
April, 2012Epid & Biostat Dep`t, UoG
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Learning Objectives
At the end of this session the student will beable to:
Define health research, research design,and research methods
Understand the differences betweenresearch and audit
Understand the different types of research
Develop research objectives of differentforms
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3
Research?
The systematic collection, analysis, andinterpretation of data to answer acertain question or solve a problem
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Health Research?
Health research is the process of obtainingsystematic knowledge and technology which canbe used for the improvement of the health ofindividual groups. It provides the basic
information on the state of health and diseasesof the population; it aims to develop tools toprevent and cure illness and mitigate its effectsand it attempts to devise better approaches tohealth care for the individual and community
(Davies 1991)
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What is Health Research?Cont..
Health Research is a systematic
collection, analysis and interpretationof data to solve a health problem.
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Purpose of Health Research
- To generate knowledge essential toeffectively promote the health of
the population.
- Without that knowledge, effective
action is impossible because it hasno logical or empirical basis.
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Research must be:
Purposeful: what do you want to be able tocontribute?
Targeted: Who are the audiences?
Credible: consider sources information, method ofdata collection, personnel involved
Timely: Is the information needed?
Research is done to find solutions to health problems.
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2) Research and audit
Although research and audit have a great dealto offer each other and should be inextricablylinked, it is important to recognise their distinctroles. Otherwise there is a danger of auditmasquerading as research but without thenecessary rigour, or research pretending to beaudit, but without any attempts to improve thequality of care given. (Black, 1992)
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Research and audit cont..
Research
aims to find the value of health care (Is anintervention effective/humane/cost-effective?)
should be generalizable to other placesand times (if properly carried out)
4
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Research and audit cont..
Audit Audit consists of reviewing and monitoring
current practice, and evaluation (comparison ofperformance) against agreed predefined
standards
Audit is directed at the maintenance andachievement of quality in health care.
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Research and audit cont..
Audit- aims to assess and monitor the provision
of health care to ensure its quality (Quality
= effectiveness, humanity, equity,efficiency)- is an ongoing activity to monitor, institute
changes then reassess
- is essentially a local activity, results beingof primary value at the specific time andplace
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Ways in which Research and Audit are linked
Research as a basis for audit Research often makes a vital contribution to audit by:
defining good quality care(Treatment of malaria by coartem)
produce accurate outcome measures
Audit as a basis for research Audit data can be used as a non-experimental basis for
evaluating health care by:
detecting dramatic effects of an intervention or rareside effects
investigating differences in use of and access toservices (equity)
optimal approach is to collect together audit data withlarge audit databases
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Criteria for undertaking audit
The issue should be a common, significant orserious problem
Any changes following audit should be likely to
benefit patients and to lead to greatereffectiveness
The issue is relevant to professional practiceand development
There is realistic potential for improvement
The end result is likely to justify the investmentof time and effort involved
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Types of research
Level of Analysis Object of Analysis
Conditions Responses
Individual and
subindividual
Biomedical Research
(Basic biological processes,structure and function of the
human body, pathologicalmechanisms)
Clinical Research
(Efficacy of preventive,diagnostic, and therapeutic
procedures, natural history ofdiseases)
Population Epidemiologic Research(Frequency, distribution, anddeterminants of health)
Health Systems research
(Effectiveness, quality, andcosts of services: developmentand distribution of resources forcare )
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Types of research cont
Biomedical Research
Example: Experiments in cell culture andin vivo demonstrate that treatment with
statins reduces production of Abeta, themain component of senile plaques, afeature of Alzheimers Disease.
Epidemiological Research
Example: Prevalence and risk factors ofcigarette smoking and khat chewing
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Types of research cont
Clinical Research
Example: studying the effectiveness ofcoartem in treating malaria
Health Systems Research
Example: Study of the underlying reasonsfor emergency hospital admission ofpatients with diabetes.
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Basic Vs Applied Research
Basic research (also called fundamentalorpureresearch) -has as its primaryobjective the advancement of knowledge
and the theoretical understanding of therelations among variables
The terms basic or fundamental
indicate that, through theory generation,basic research provides the foundation forfurther, sometimes applied research.
http://en.wikipedia.org/wiki/Basic_researchhttp://en.wikipedia.org/wiki/Knowledgehttp://en.wikipedia.org/wiki/Knowledgehttp://en.wikipedia.org/wiki/Basic_research -
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Basic Vs Applied Researchcont..
It consists of pure basic research andstrategic basic research.
Pure basic research is carried out withoutlooking for long-term benefits other thanthe advancement of knowledge.
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Basic Vs Applied Researchcont..
Strategic basic research - is directed tospecified broad areas in the expectation ofuseful discoveries.
It provides the broad base of knowledgenecessary for the solution of recognizedpractical problems.
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Basic Vs Applied Researchcont..
Basic research is conducted to
address fundamental questions about
the biological, Behavioral, and
social mechanisms,
which underlie wellness and disease
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Basic Vs Applied Researchcont..
Applied research
Is original work undertaken in order toacquire new knowledge with a specificapplication in view.
Is a research that seeks to solve practicalproblems
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Research Methods
Refers to: The practices and techniques used to collect,
process and analyze the data (e.g What type ofexperiment or survey);
The sample size and methods of sampling In the case of experiments and analytical
studies, of assignment to experimental andcontrol groups
The research proposal will need to present andjustify the appropriateness of the chosenresearch methods
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Overview of research process
What is the problem?
Define your initial objective
Search literature
Modify your objective based on the
information you get from literatureWrite the full proposal guided by the objective
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2424
Where
are we?
Youre 30metres
above the
ground in aballoon.
You mustbe a
researcher
Yes.How
did you
know?
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2525
Because whatyou told us is
absolutely
correct but itis completely
useless.
You must
be policy-makers.
Yes, weare. How
did youknow?
Because you dont
know where youare, you dont know
where youre going,
and now youre
blaming me foranswering your
question precisely.
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What is A Problem?
What is What should be!
Exist
Ideal
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Situation:In District X (pop. 145,000) sanitary conditions are poor
(5% of households have latrines) and diseasesconnected with poor sanitation, such as hepatitis,gastroenteritis and worms, are very common. TheMinistry of Health has therefore initiated a sanitation
project which aims at increasing the percentage ofhouseholds with latrines by 15% each year. The projectprovides materials, and the population should providelabour. Two years later, less than half of the target hasbeen reached.
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Discrepancy:
35% of the households should have latrines,but only 15% do have them.
Possible answers????
Research Problem or not?
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Problem situation: District A: 125 HIV-positive adultswere coming to the hospital every day as part of aDOTS programme to take medication for TB; last
month for one entire week, none of the 125patients received any medication
Discrepancy?
Problem question? What are the factors responsible for125 patients failing to receive any treatment?
Possible answer: During the week a very heavy
rainstorm caused flooding that washed out several roads a resupply truck could not reach the hospital for oneweek
Research Problem or not?
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The reasons for this difference is unclear
More than one possible answerto the question
or solution to the problem
Whether a problem requires research or not
?
? ?
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7 Criteria for selection of a researchproblem
Relevance (widespread, who is affected, severity)
Avoidance of duplication
Feasibility (available resources)
Political acceptabilityApplicability
Urgency
Ethical applicability
Prioritization: 1= LOW ; 2= MEDIUM; 3= HIGH
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1. Relevance
How large or widespread is the problem?
Who is affected?
How severe is the problem?
2. Avoidance of duplication
find out whether the suggested topic has been
investigated before
either within the proposed study area or in
another area with similar conditions
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3. Urgency of data needed (timeliness)
How urgently are the results needed for making a decision
or developing interventions at various levels (from
community to policy)?
Consider which research should be done first and which
can be done later
4. Political acceptability
research a topic which has the interest and support of the
local/national authorities
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5. Feasibility
Think about the resources required to conduct the study
manpower, time, equipment and money that are locally
available
possibility of obtaining technical and financial assistance
from external sources
6. Applicability of possible results/recommendations
Is it likely that the recommendations from the study will
be applied?
7.Ethical acceptability
the possibility that we may inflict harm on others while
carrying out research
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Problem Analysis
Identify factors that may have contributed to the problem
Clarify the relationship between problem and the
contributory factors
PROBLEM
FACTOR
FACTOR
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Delay intreatment
Delay indiagnosis
Prolongedduration for
culture &sensitivity
(6-10 weeks)
Failure of anti TB drugsto control TB in recent
years
Attempts todevelop
rapiddiagnosisprocedure
X Ray orsmear
microscopy
is inadequatefor use in D& T
Growing resistance ofMycobacterium species to anti TB
drugs
Poor compliance of patients
Patients take care at GP
Not providing HE
Self medication
Misuse of anti-TB drugs
Availability of anti-TB drugs in market
Problem statement
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Constitutes the scientific justification for thestudy;
Gives an empirical basis to describe thesituationClearly specifies the gaps (in existing
knowledge and/orcontroversy and inconclusive evidence)
Defines the objective of study and conveys the
questions orbroader issues
Problem statement
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A logical sequence for presenting the statementMagnitude, frequency and distribution: Affected
geographicalareas & population groups affected by the problemProbable causes of the problem: What is the currentknowledge
of the problem and its causes? Is there consensus?controversy? conclusive evidence?Possible solutions: In what ways have solutions to theproblembeen attempted? What has been proposed? What are theresults?Unanswered questions: What remains to be answered?What areas have not been possible to understand,determine, verify, or test?
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Formulation of the Problem Statement
Context Socio-economic and cultural characteristics
and an overview of health status and the health care
system
Nature of the problem
An analysis of major factors and convincing argument
Any solution that have been tried in the past, how well
they have worked, and why further research is needed.
Type of information expected to result from the project
and how this information will be used to solve problem.
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4/25/2012 Berihun M. 41
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Formulation of Research
ObjectivesBerihun Megabiaw (MD, MPH)
Dep`t of Epid and BiostatUoG
March 2012
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A Research QuestionUncertainty about something in the
hospital/treatment procedure/populationthat theinvestigator wants to resolve by makingmeasurements on his/her study subjects
MedicalArticles
Conferences
Observations
Applyingnew
concepts toold issues
ResearchQuestion
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Research questions:
- Formulated when insight intothe problem being studied is notsufficient.
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5 CRITERIA for A Good Research Question
Feasible : Adequate no. of subjects, adequate technicalexpertise; afford in time and moneyF
I
N
E
R
Interesting to the investigator
Novel : Previous findings - confirm or refute, extend New
findings
Ethical : Autonomy, Benefits and Risks, Justice
Relevant : To scientific knowledge, clinical & health policyfuture research directions
E l f R h Q ti
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Examples of Research Questions(Articles, Research Reports, Congress Abstracts)
What are the patterns of anti-malarial prescriptions at referral
Hospitals?
What are the socioeconomic background
and behavior of adolescent pregnancy?
What are the traditional birth practices of
rural Ethiopian women?
Wh t f t b d f
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What formats can be used forstating research objectives?
Research objectives can be stated as:
A) Questions: The objectives of this studyare to answer the following questions
B) Positive sentence: The objectives of thisstudy are to assess
C) Hypothesis: The objective of this study is
to verify the following hypothesis...
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Formulating Objectives cont..
A good question includes the following elements:-
The patient or client in question (the Problem)
The Intervention (or exposure) being considered
A Comparison - an alternative intervention orgroup
The Outcome of interest
This format (PICO) does not fit with all questions
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Formulating Objectives
Example: Imagine you are a member of NationalCigarette Smoking Cessation Group.
One issue that the group considers is nicotinereplacement therapy for people who want to stop
smoking.
The other group says advising people to stopsmoking will suffice.
The debate continued but they couldnt agree.
Formulate a research question for the aboveproblem
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Formulating Objectives cont..
Answer
Problem Intervention Comparison Outcome
For smokers
who want togive upsmoking,
does nicotine
replacementtherapy,
when
comparedwithindividualsrelying on
advice only,
increase their
chance ofgiving upsmoking?
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It summarizes what is to be achieved
by the research / study
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To focus the study (Narrow the scope)
To avoid collection of unnecessary data
Facilitate the development of research
methodology Help to orient the collection, analysis,
interpretation and utilization of data.
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WHERE AREYOU GOING?
If you are not
certain of where youare going, you may
well end up
somewhere else
(and not even know
it!).
Set objectiveEvaluate performance
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General Objective
What is expected to be achieved by
the study ingeneral terms
Specific Objectives
Breaking down the general objectiveinto smaller, logically connected
parts
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Objective should be closely related toproblem statement
Example problem:
Low utilization of Antenatal Care(ANC) General Objective:
To assess the reasons for low utilization of
ANC services in District X.
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PROBLEM IDENTIFICATION,ANALYSIS AND STATEMENT OF
THE PROBLEM
CHOOSING OF RESEARCH AREA
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Should address various aspect of problemand factors influencing/associatedwith/determining the problems.
The first specific objective usually focuseson quantifying or specifying the problem
Should specify-
What will do in the study Where
For what purposes
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1. Determine the level of utilization of ANC inDistrict X over the years 1998 and 1999.
2. Identify whether there are variations inutilization of ANC service, related to the seasonand type of clinic.
3. Identify socioeconomic & cultural factors thatmay influence the mothers' utilization of ANCservices
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Cover the different aspects of problem and itscontributing factors in acoherent way and logicalsequence
Clearly phrased in operational terms by specifyingwhat you are going to do, where and for whatpurpose
Considering local conditions to berealistic
Useaction verbs
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-determine -verify -identify-describe - find - compare
calculate - establish - explore To compare: the level of utilization of ANC
services among various S.E groups.
To establish: the pattern of utilization of ANC
services in various seasons of the year.
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Avoid use of non-action verbs
Vague
Examples:
to appreciate
to study
to understandto know
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Specific
Measurable
Achievable
Realistic
Time bound
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Clear and comprehensive objective is
critical
To the dev`t of all other components of a
research design, subsequent datacollection, analysis, reporting & utilizationof data.
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Group work!
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pResearch Question and Objectives
1. Formulate research questions (03)
2. Write general and specificobjectives for them
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