Copyright IngeniousWellness LLC 2015 All rights reserved. Agenda. Diffusion of innovalon Scholarly massage. Research fields, agendas, challenges
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1 5/8/15 Secondary data analysis: An untapped resource for massage research Virginia S. Cowen, Ph.D., L.M.T. Copyright IngeniousWellness LLC 2015 All rights reserved. Agenda Diffusion of innovalon Scholarly massage Research fields, agendas, challenges Data Finding, mining, analyzing, reporlng ConsideraLons ethical and mathemalcal Examples of data driven research ApplicaLon to massage profession Copyright IngeniousWellness LLC 2015 All rights reserved. 1
2 InnovaLon InnovaLon Development ImplementaLon AdopLon InsLtuLona- lizalon CommunicaLon Channels Social System Sustainability Diffusion DisseminaLon RelaLve advantage Maintenance CompaLbility Complexity Trialability Observeability Scholarly Massage Research Massage techniques cross fields Outcomes Academic peril: publish or perish Research = currency Scholar interests Outcomes ApplicaLon Following the funding The Island of Endless Pilot Studies 2
3 Research & Scholarship Boyer (1990) On Scholarship. Discovery ApplicaLon IntegraLon Teaching Basic Science TranslaLonal Clinical Outcomes Clinical Delivery Learning Outcomes Research & Development for Clinical Trials Pre- clinical Phase I Safety Phase II Efficacy Phase III & IV ComparaLve Efficacy Reviewing Research Research Agendas Editorial PosiLon Paper Literature Review Outcomes Research DescripLve Experimental/InferenLal Meta Analysis Small Sample Sizes Issues with blinding 3
4 Data- driven research Secondary data Non- experimental research ProspecLve or retrospeclve DescripLve or inferenlal Primary or secondary outcomes Minimize bias Sampling RandomizaLon Ethics for subjects Primary Outcomes Physiological Range of molon Pain Blood pressure Heart rate FuncLonal Daily aclviles Human performance Secondary Outcomes Psychosocial Quality of Life Depression Anxiety Perceived stress Medical diagnoslc measures 4
5 Quan3ta3ve DescripLve Frequencies CrosstabulaLon Mean, median, mode InferenLal EffecLveness ANOVA or t- Test Linear relalonships CorrelaLons Qualita3ve Meanings PercepLons Ideas Aftudes Values Needs SaLsfacLon Research QuesLon: Back Pain Ernst, E. (1999). Massage therapy for low back pain: a systemalc review. Journal of Pain and Symptom Management, 17(1), RCTs (massage only) Total n=397 Treatments Stroking, gliding, hot water jets, not specified Outcomes Scales: Owestry, Roland- Morris, custom- developed, VAS Straight- leg test, trunk ROM Analgesic consumplon Furlan, A. D., Imamura, M., Dryden, T., & Irvin, E. (2009). Massage for low back pain: an updated systemalc review within the framework of the Cochrane Back Review Group. Spine (Phila Pa 1976), 34(16), RCTs (massage alone or in combinalon w/ exercise & educalon)) Total n=1596 (across studies) Treatments Massage (hands- on or mechanical device) Outcomes Pain, dimensions of pain FuncLonal disability Work- related measures 5
6 Overall Ques3on OperaLonalize Literature review results Research hypothesis ProspecBve design idea Secondary data source Variables Analysis approach Example #1: Safety Is massage safe for back pain? Chronic (>12 weeks) Idiopathic Adults 18+ Measurement (pain, ROM) Single massage treatment Inconclusive (no reported adverse events) A single massage can safely improve reported pain and ROM in adults with chronic, idiopathic back pain Mixed methods w/small sample Aggregated massage clinic records Any reported adverse events for back pain (primary) VAS, aclve trunk flexion (secondary) Frequency distribulon of adverse events DescripLves (cross- tab, frequency distribulon) ANOVA, paired sample t- test Example #2: Efficacy Overall Ques3on OperaLonalize Literature review results Research hypothesis ProspecBve design idea Secondary data source Variables Analysis approach Can massage improve back pain? Chronic (>12 weeks) Idiopathic Adults 18+ Measurement (pain, ROM) Single massage treatment Inconclusive (double- blinding not possible, small samples for quasi- experimental trials, small body of research) A single massage can improve reported pain and ROM in adults with chronic, idiopathic back pain compared to no treatment Quasi- experimental w/small sample Aggregated massage clinic records VAS, aclve trunk flexion ANOVA, paired t- test 6
7 Example #3: ComparaLve Efficacy Overall Ques3on OperaLonalize Literature review results Research hypothesis??? ProspecBve design idea Data source Variables Analysis approach How many massage treatments relieve back pain? Chronic (>12 weeks) Idiopathic Adults 18+ Measurement (pain, ROM) Massage treatment >30 minutes duralon Inconclusive (double- blinding not possible, few trials with small samples) Quasi- experimental w/small sample Aggregated massage clinic records Treatment length, frequency (sessions/week, # of weeks) Complementary approaches (medicalon, exercise) VAS, aclve trunk flexion CorrelaLon, DescripLves stralfied by group Example #4: ComparaLve Efficacy Overall Ques3on OperaLonalize Literature review results Research hypothesis ProspecBve design idea Data source Variables Analysis approach What techniques are most effec3ve for back pain? Chronic (>12 weeks) Idiopathic Adults 18+ Measurement (pain, ROM) Massage treatment >30 minutes duralon Inconclusive (double- blinding not possible, few trials with small samples) Gliding and kneading of hip extensors increases ROM & decreases pain in palents with insufficient trunk flexion Quasi- experimental, mulb- armed study w/medium sample Aggregated massage clinic records Treatment length, frequency (sessions/week, # of weeks) Complementary approaches (medicalon, exercise) VAS, aclve trunk flexion ANOVA, descriplves, stralfied groups 7
8 ConsideraLons Large sample sizes in exislng datasets Less expensive than prospeclve, planned studies Limited informalon may be available in records Designs ProspecLve planning ahead with variables RetrospecLve assessing what happened Survey research (demographics, symptoms, condilons) Treatment- seeking paperns AggregaLon ConfidenLality/anonymity, proteclon of subjects SLll involves costs Can contribute to evidence- based praclce Evidence- based praclce Clinical Knowledge Research Evidence PaLent Values Available Resources Based on: Charles, C., Gafni, A., & Freeman, E. (2011). The evidence- based medicine model of clinical praclce: scienlfic teaching or belief- based preaching? J Eval Clin Pract, 17(4), DiCenso, A., Ciliska, D. & Guyap, G. (2005) IntroducLon to evidence- based nursing. In Evidence- Based Nursing: A Guide to Clinical PracLce (eds A. DiCenso, G. Guyap & D. Ciliska), pp London: Mosby. 8
9 5/8/15 PotenLal for InnovaLon AggregaLon of exislng data reflects LMT PracLce paperns Clients Issues Techniques Larger sample sizes Outcomes relevant to massage educalon ComparaLve effeclveness studies Copyright IngeniousWellness LLC 2015 All rights reserved. QuesLons? Thoughts? Ideas? Copyright IngeniousWellness LLC 2015 All rights reserved. 9
10 Appendix A: QuanLtaLve Methods DescripLve Experimental PredicLve Cohort/ Case Control RetrospecLve ProspecLve True Experiment (randomized, controlled) Quasi- experimental (controlled, not randomized) Case Study Linear Correlational Univariate Multivariate Meta-analysis Appendix B: QualitaLve Methods DeconstrucLonist Case Study Ethnography NarraLve InterpreLve CriLcal NaturalisLc/ Field Study Discourse ObservaLon Phenomenology 10
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