Introduction to Health Research PDF

8/1/2019 BASIC COURSE IN BIO-MEDICAL RESEARCH nie.gov.in Dimension of health research BASIC COURSE IN BIO-MEDICAL RESEARCH Theoretical res...

8/1/2019 BASIC COURSE IN BIO-MEDICAL RESEARCH nie.gov.in Dimension of health research BASIC COURSE IN BIO-MEDICAL RESEARCH Theoretical research and applied research Preventive and therapeutic research Bench based research and bedside research Exploratory research and confirmatory research Implementation research and translational research nie.gov.in 1  8/1/2019 Fundamental principles to be followed BASIC COURSE IN BIO-MEDICAL RESEARCH Planning stage is very critical – spend enough time and involve the right people in planning Team work is critical Three levels of review are essential Scientific review: novelty, rationality, justification Ethics review: human subjects protection Regulatory review: foreign funding, sample shipment, intellectual property, exchange of visitors nie.gov.in Process of health research BASIC COURSE IN BIO-MEDICAL RESEARCH Ensure that data is collected systematically Draw meaningful conclusions Make appropriate decisions Take appropriate actions for prevention and control of diseases, conditions: Evidence based actions These should help in reduction of suffering and ultimately improve health and well-being of the community nie.gov.in 2  8/1/2019 Breadth and depth of inquiry in health research BASIC COURSE IN BIO-MEDICAL RESEARCH Human host: healthy, susceptible, with disease, dead Surrounding environment and society: climatic factors, housing, vectors, animals, socio-cultural practices, family structure Health care infrastructure and delivery nie.gov.in Broad scope of health research BASIC COURSE IN BIO-MEDICAL RESEARCH Getting additional or new information Are more of diphtheria and pertussis reported among adults in recent times? What are the differences in full genome structure of HBV and HEV? Verifying and confirming available information Are etiologies of pediatric pneumonia different in the children aged 5 or less in developed and resource limited countries? Have the incidence and complications of diabetes changed with increasing consumption of pre-cooked and packaged food? Explaining cause and effect relationship Does presence of a particular co-receptor [cause] on CD4 cells protect against HIV infection [effect]? Are breast cancers [effect] more common in breast implant [cause] recipients? nie.gov.in 3  8/1/2019 Broad scope of health research BASIC COURSE IN BIO-MEDICAL RESEARCH Testing new drugs, vaccines, tools or interventions for prevention, treatment and control of a disease Can INH prophylaxis delay onset of tuberculosis in HIV infected persons? Will introduction of smokeless stoves result in reduction of respiratory morbidity and mortality in rural areas? Evaluating ongoing programs and assessing feasibility of new programs Is injectable iron sucrose a better alternative to deal with pregnancy related anemia than oral iron? Will the Integrated Disease Surveillance Program be able predicting the epidemics of influenza and bird flu in India? nie.gov.in Making the right choice of study design BASIC COURSE IN BIO-MEDICAL RESEARCH Qualitative studies or Quantitative studies Observational studies or Experimental studies Retrospective studies or Prospective studies nie.gov.in 4  8/1/2019 Some critical considerations in planning phase BASIC COURSE IN BIO-MEDICAL RESEARCH There should be adequate justification to conduct the research study The research question should have clarity and focus Case definitions of study variables and outcomes should be standard and unambiguous Sample and sample size: Should be representative of the population [External validity or generalizability] Should be adequate [power to draw meaningful inferences] nie.gov.in Research can never be free of errors, but BASIC COURSE IN BIO-MEDICAL RESEARCH errors can be predicted and minimized Random error representing wrong result due to chance: unknown sources of variation that can distort findings in either direction Can be minimized by increasing sample size and increasing precision Systematic error signifying wrong result due to bias - mostly due to variation that would distort the results in one direction Can be minimized by improving study design nie.gov.in 5  8/1/2019 Challenges in designing and implementation BASIC COURSE IN BIO-MEDICAL RESEARCH of research studies In a scenario when we desire to study the relationship between a variable and an outcome Confounders: Affect both study variable as well as outcome Effect can be minimized by proper study design and through stratified analysis Effect modifiers: Can alter [generally negatively] the relationship between the study variable and outcome by independently affecting outcome Good to be aware of them through adequate literature review and not to include them in the study nie.gov.in Study methods and measurements: Major issues BASIC COURSE IN BIO-MEDICAL RESEARCH Pilot study Study participants: Inclusion and exclusion criteria, recruitment targets and strategies Data collection instruments Measurements tools and assay Plan for statistical analysis Quality control and assurance at all levels nie.gov.in 6  8/1/2019 Focus of health research BASIC COURSE IN BIO-MEDICAL RESEARCH How can health of the population be improved? Can we predict occurrence of a disease in an individual? How can various diseases be prevented? How can we effectively cure the diseases and reduce the associated morbidity and mortality? What are various societal, community based and programmatic interventions for disease prevention and control? nie.gov.in Health research aims at finding answers or BASIC COURSE IN BIO-MEDICAL RESEARCH practical solutions at individual and community levels At individual level Promote healthy behavior, prevention at individual level, early diagnosis, adequate and appropriate treatment, rehabilitation At community level Improve community behavior and practices, prevention and control programs, support to affected people, stigma reduction Healthy individuals build healthy nations! nie.gov.in 7  BASIC COURSE IN BIO-MEDICAL RESEARCH nie.gov.in 8/1/2019 8