Just what research design am I using? Shona J. Kelly Professor of Interdisciplinary Research

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Transcription:

Just what research design am I using? Shona J. Kelly Professor of Interdisciplinary Research 1

Presentation Plan O an introduction to the basics of research study design O a brief overview of the most common designs O exhortation to use mixed methods 2

Background O how I became an 'expert' O badly taught and badly described O interdisciplinary differences in expectations O no single decent textbook/guide O much misuse of jargon 3

Start with the research O Do you want to... question O show that a government programme works O show that intervention A is better than intervention B O demonstrate that X causes Y O describe how a client uses a service O see how a new role fits into a team O count how many people... O measure knowledge about a topic O... 4

Research Design Basics 1 O the terminology is poorly used O Start by describing your project with these 4 classifications and then select your design 1. Purpose 2. Time Frame 3. Context 4. Structure 5

Classification: Purpose O Exploratory O Descriptive O Explanatory none of these are a sufficient label 6

Classification: Time Frame O Retrospective Studies O Prospective Studies O Cross-sectional Studies O Longitudinal Designs none of these are a sufficient label 7

Classification: Context O field setting O laboratory setting O clinical setting none of these are a sufficient label 8

Research Design Basics 2 O it is not qualitative v quantitative O the fundamental division is between experimental v non-experimental O and the key to understanding this is how you engage with the research participant 9

Classification: Structure O (True) experimental designs O Quasi-experimental designs O non-experimental designs This should be the basis for choosing your research design 10

Criteria for experimental designs O random assignment O so, a minimum of 2 groups O control - experimental NOT statistical O manipulation O YOU must do something O RCTs are only one little subtype of experimental designs 11

Criteria: Quasi-experimental designs O one of the experimental criteria is missing O usually randomisation O term frequently misused 12

Non-experimental designs O makes up most of published health research O just because there are numbers/counts doesn't make it experimental O a mixed bag... includes surveys, using administrative data, interviews, analysis of text, etc 13

'Rigor' hierarchy O NIHR or NICE O the 'official' list O not reality O particularly for 'soft' stuff like patient experience, public health, or problems with multiple causes and solutions 14

General principles that sit behind research O the purpose of peer review O reproducibility - can someone replicate? O generalisability O blinding to remove unconscious effects O bias as opposed to random error 15

Recommendations O Don't get stuck in a philosophical debate about methodology O Go as rigorous as can be reasonably expected O most researchers DON'T use multiple methods because they were 'apprenticed' O Don't assume qualitative is easier O Make sure any data you might need actually exists 16

Discuss O Break into pairs and discuss your research 17

A bit more detail on selected study designs 18

True Experimental Designs independent groups - NO repeated measures repeated measures designs single factor designs posttest only random groups design one-way repeated measures design randomized control trial factorial design multi-factor designs crossover design latin squares design randomized block design nested design? Solomon four-group design Shona J Kelly 2011

Quasi-Experimental Designs one group designs multi-group designs pre-experimental designs non-equivalent posttest-only control group design one-group pretest-posttest design non-equivalent pretest posttest control group design time series designs Shona J Kelly 2011

Non-Experimental Designs descriptive designs exploratoryanalytical designs phenomenology biography case study case control study cohort Studies Panel Studies cross sectional/comparative/ correlational designs grounded theory linkage studies demography ethnography narrative analysis Shona J Kelly 2011

Why are there all these different designs? O the nature of your question O the nature of your study participants O ethics or governance issues O cost and time available O Let's look at some specific designs 22

Does this intervention increase seat belt use? O could use an RCT but asking participants if they use one before may remind them to use them 23

Benefits must continue O for example ending benefits may lead to homelessness 24

What is the optimal length of a TV advert campaign? 25

Participants might share what they learn about your intervention... O You can randomise groups 26

Does this treatment improve a patient's condition? O Instinctively use this design. But be careful! Without a comparison group how do you know they didn't just get better anyway? 27

Can't ethically expose people to hazardous substances O find a group with a RANGE of potential exposure O term frequently misused 28

What causes this radicalisation? O blinding crucial O relies on previous research O when do you approach patients? 3 29

How many people have diabetes? O two choices - both have limitations 30

Why don't patients take their tablets? O two choices - both have limitations O mixed methods best choice 31

Additional issues - data O Where is your data coming from? O don't assume the data already exists - check and confirm YOURSELF O data storage has changed over time so older records are more parsimonious O linking data is probabalistic 32

Additional issues - ethics O Understand the ethical and governance issues O who gives permission for access to people or data? O who owns the data if you didn't collect it? O change of ownership change of access 33

Mixed Methods O YES!!!! maybe always! O But... not an excuse for poor quality or lack of rigor O stop agonising over combining them in conclusions O convergent parallel mixed methods O triangulation O some examples 34

Example: SRH 1 O In general how would you describe your health? excellent, very good, good, fair or poor. O focused on E VG and G O interested in gender and SES differences O data: 23 interviews; health survey data; provincial healthcare records data O analysed independently then fused and revisited some analyses 35

Example: SRH 2 stress health models physical illness activity limitations smoking positive measures alcohol negative measures mental health block take responsibility block social influences block physical health block self-reported health care visits education community factors physical activity medical screening body image diet sources of health information compared to whom relationships social status immigrants 36

Example: role substitution 1 O NIHR call O background O shortage of doctor trainees in region O out of hours & weekend care O HEE funded 300 ANP posts O little research and most qualitative which suggested problems 37

Example: role substitution 2 O We proposed 1. Calderdale Framework 2. quasi-experimental component 3. ethnographic observation 4. economic evaluation 5. synthesis & dissemination into practice 38

Example: DNA 1 O 10-15% of hospital outpatient appointments are missed O Sionnadh - literature review O UK situation O little studied O easy interventions already in place O 'easy' place to save money 39

Example: DNA 2 O multiple causes: O patient factors - age, ethnicity, economics O purpose of appointment - pre-op, chronic conditions, post-op follow-up O clinic factors - patient mix, hierarchy', research O appointment system - externally supplied, mostly unchangeable, 40

.. Current Working Model

Questions 42