Met deze samenvatting kun je gegarandeerd Research Methods van de master Health Sciences halen! Icm de college aantekeningen zijn deze documenten getest op het behalen van ruim een 9!
Veel succes met leren!
Research methodology
The purpose of health science/research is finding an objective, generalizable, ‘truth’.
Two pespectives:
Positivism (objectivism)
- Reality can be observed
- Observes facts of one single reality Deductive
- Value-free - Begins with hypothesis and theories
- Measures and predict - Manipulation and control
- Generalizable - Uses formal instruments
- Bijv. Noteren hoe veel dagen iemand heeft gewacht - Experimentation/survey/structured interviews
op een afspraak - Seeks for confirmation/rejection
- Deductive - Ex. Theory of planned behavior 🡪 hypothesis:
exposure to fast-food> consumption 🡪 Observation:
Interpretavism (constructivism) do the test 🡪 confirmation/rejection
- Truth and meaning are constructed by the
person/researcher (subjects) Inductive
- Researchers are inherently view through their - Thick description
frame of reference - End with hypotheses and grounded theory
- Multiple realities (are experienced), and meaning is - Emergence and portrayal
not stable - Researchers as instrument
- Constructs reality - Seeks for (contextual) theory
- Observations are value-bound - Ex. Observation: views of fastfood junkies 🡪
- To deeply understand pattern> absence of lifegoals 🡪 hypothesis> no
- Time and context bound hypothesis/generalization lifegoals > fastfood 🡪 theory >lifegoal
- Bijv. Aan de persoon vragen hoe diegene de
wachtlijst heeft ervaren
Deductive: confirm/reject theory. Look at your data with clear units of analyses. Is structured.
Inductive: open and develop theory. Analyze data for emerging patterns. Theory unstructured.
(Quasi)Experimental
- Determine causality
- Aim to generalize from experiment
- Associated with positivism/deductive approach
- Not randomly, use existing groups 🡪 Quasi
Analytical survey
- To explore and test proportions/associations/predictors between variables
- Highly deductive 🡪 je weet waar je naar op zoek bent!
Phenomological studies
- Aims for contextual description and analyses of ‘phenomena’
- Emphasize inductive logic
- Seeks the opinions and subjective accounts and interpretations of participants
- Relies on qualitative analyses of data
- Inductive
(Participatory) action research
- Research that aims to change practice in real life
- Collaborations between researches and practitioners and users (e.g. patients, community members)
- Iterative designs (herhaling)
- Mixed methods
- Understanding of perspectives in order to determine change and (often) measuring the change.
- Deductive and inductive reasoning
Iterative🡪 telkens opnieuw dingen doen tijdens onderzoek doen
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,Research objective/question
Needs to be useful, realistic, feasible, clear and informative
- What is the big problem/issue
- What is (not) know/done about it?
- What am I going to make known about
it?
Reliability: the same result if the situation is
stable
- variability because of random
fluctuations
- no specific direction
The domain reliability refers to the degree to
which the measurement is free from
measurement error, and it contains
- internal consistency
- reliability
- measurement error
Internal consistency:
- The interrelatedness among the items
- Multi item (or multi task) instrument/
PROM
- Latent (non observable characteristics)
Reliability: test retest design
Inter rater
- different raters on the same occasion
Or better: different raters on different occasions
This reflects daily practice more adequately.
The construct should not have changed between the 2 measurements: stability!!
- Short interval between the 2 measurements
- And/or: external criteria for stability
Stability of patients by external criteria
- 7 point scale: 1 = ’completely recovered’ to 7 ‘worse than ever’; Stability defined as 3 = not changed
🡪 Statistics: ANOVA
ICC= between subject variance / (between + within subject variance)
Kappa: (p0-pe/(1-pe)
Measurement error
the systematic and random error of a patient’s score that is not attributed to true changes in the construct to be measured.
Measurement error is expressed as SEM
SEM = standard error of measurement
= standard deviation of repeated measurements in one person
SEM = var (error)
Method of bland and altman
Interval and ratio scale; measurement error is expressed
in the same units as measurement
D +/- 1,96 * SDd
D= systematic error
d= random error
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, Validity: the result that one really aims for
- systematic deviation from the true value
- magnitude and direction
The domain validity refers to the degree to which an outcome measure measures the construct it purports to measure, and
contains the measurement properties:
● content validity, including face validity
● criterion validity
● construct validity,
Content validity
The degree to which the content of an HR-PRO instrument is an adequate reflection of the construct to be measured
Comprehensibility of items of response options; Relevance of items of response options; Comprehensiveness
Content validity is the most important measurement property 🡪 Often overlooked/neglected…
- Face validity
The degree to which (the items of) an HR-PRO instrument indeed looks as though they are an adequate reflection of
the construct to be measured. Makes it sense? - vague concept. The first view.
Criterion validity: Compare change scores to Golden Standard
Relationship between test and criterion (gold standard). Often used in diagnostic research
- Concurrent validity: test & criterion (more or less) simultaneously. E.g. range of motion and X-ray
Construct validity: Hypothesis testing regarding change scores
- Structural validity: The degree to which the scores of an HR-PRO instrument are an adequate reflection of the
dimensionality of the construct to be measured
e.g. structural validity:
Factor structure of Guy's Neurological Disability Scale
Longitudinal validity = responsiveness
Content validity: most important measurement property according to COSMIN
Criterion validity: relationship with gold standard
Construct validity: Structural validity (one dimension/factor or more?); hypotheses testing (needed in absence in golden
standard)
Responsiveness is longitudinal validity: ‘’am i measuring what i aim to measure’’
Internal validity: the extent to which its design & conduct are likely to prevent systematic errors, or bias
Critria for internal validity RCT
- Randomisation procedure
- Comparable groups at baseline
- Blinding of randomisation allocation to: patients; outcome assessor; care provider; statistician or researcher
- Compliance to the protocol by patients ‘therapie trouw’ and care providers
- Loss-to-follow-up
- Intention-to-treat analyses
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