Week Two Lecture PDF

Searching for Research Evidence NUSC 2P70 Week Two Stephen Shears, MN RN House Keeping: Due date for March 28th for the paired Assignment Guess lecture not Tested! Copyright © 2019 Wolters Kluwer · All Rights Reserved  Chapter 4 Reading and Critiquing Research...

Searching for Research Evidence NUSC 2P70 Week Two Stephen Shears, MN RN House Keeping: Due date for March 28th for the paired Assignment Guess lecture not Tested! Copyright © 2019 Wolters Kluwer · All Rights Reserved  Chapter 4 Reading and Critiquing Research Articles Types of Research Reports Presentations at professional conferences – Oral presentations (can vary in length and breadth) – Poster sessions Journal articles (most common) – Papers often subjected to peer review – Peer reviews are often blind (reviewers are not told names of authors and vice versa). -many differing types of research - Peer review (other researcher and academic will volunteer their time to review a study and is a blinded review which goes to the original author prior to publication) -This system isn’t perfect (there are peer reviewed articles which can be very false) Copyright © 2019 Wolters Kluwer · All Rights Reserved Content of Research Journal Articles IMRAD Format – Title and abstract Introduction Method Results And Discussion References - Almost always follows a very specific basic layout Copyright © 2019 Wolters Kluwer · All Rights Reserved Title and Abstract Title – Qualitative studies: Title normally includes the central phenomenon and group under investigation. – Quantitative studies: Title communicates key variables and the population (PICO components). Abstract: brief description of major features of a study at the beginning of a journal article (very high level of summary) - title and abstract are the main points to start with regarding understanding general ideas of the journal article Copyright © 2019 Wolters Kluwer · All Rights Reserved Components of the Introduction Description of central phenomena, concepts, or variables (what are we going to be looking at in this article?) Study purpose, research questions, or hypotheses Review of literature (very important; Lit-Review, explains why this research matters for the type of research) Theoretical/conceptual framework (ex. a nurse theories) Study significance, need for study (states if the research is necessary; almost like a sales pitch to demonstrate necessity) Copyright © 2019 Wolters Kluwer · All Rights Reserved Method Section: Quantitative Studies Research design Sampling plan (ex. convenient sampling; which has draw backs but also benefits) Methods of measuring variables and collecting data (what tool are you using; how are you getting the data? & provide an explanation of why your choice this particular tool) Study procedures, including procedures to protect participants (large aspect of research is surrounded and bound by ethical situations; to not use deception, reduction of psychological, physical and other stresses) Analytic methods and procedures (explain why this tool makes sense for this research) (will vary dependent on style of research) Copyright © 2019 Wolters Kluwer · All Rights Reserved Method Section: Qualitative Studies Discuss many of the same issues as quantitative researchers but with different emphases (due to this research being more related to lived experiences) Provide more information about the research setting and the context of the study Describe the researchers’ efforts to enhance the integrity of the study Copyright © 2019 Wolters Kluwer · All Rights Reserved Question Tell whether the following statement is True or False. The review of literature is typically found in the method section of the research report. a. True b. False Copyright © 2019 Wolters Kluwer · All Rights Reserved Answer b. False Rationale: The review of literature is usually found in the introduction of the research report. Copyright © 2019 Wolters Kluwer · All Rights Reserved  Results Section Findings – Quantitative studies The names of statistical tests used The value of the calculated statistic (see p-values and statistical raw data) Statistical significance Level of statistical significance Index of how probable it is that the findings are reliable Copyright © 2019 Wolters Kluwer · All Rights Reserved Results Section—(cont.) Findings – Qualitative studies Findings often organized according to major themes, processes, or categories identified in the analysis Almost always includes raw data—quotes directly from study participants (ex. quotes right form the participants) Copyright © 2019 Wolters Kluwer · All Rights Reserved Discussion Section Interpretation of the results (not just the raw data but the explanation of what the results mean) Clinical and research implications Study limitations and ramifications for the believability of the results (Ex. Money/ budget restrictions, sample size [pilot study to for proof of concept], & any conflicts of interest) Copyright © 2019 Wolters Kluwer · All Rights Reserved  Question Tell whether the following statement is True or False. A researcher would describe the limitations of the study in the results section of the report. a. True b. False Copyright © 2019 Wolters Kluwer · All Rights Reserved Answer b. False Rationale: The study limitations are typically described in the discussion section of the report. Copyright © 2019 Wolters Kluwer · All Rights Reserved Why Research Articles Are Hard to Read? Compactness—page constraints (how the page is laid out and word constraints) Jargon (very compact language; and concise scientific language) Objectivity, impersonality (no personal flare or colorful language; non personal, cold technical language) Statistical information – Last two especially prominent in quantitative research articles Copyright © 2019 Wolters Kluwer · All Rights Reserved Tips on Reading Research Articles Read regularly, get used to style. Read copied articles—underline, highlight, write notes. Read slowly. Read actively. (like underlining, highlighting and notes) Look up technical terms in glossary. Don’t be intimidated by statistics—grasp gist of story. “Translate” articles or abstracts. Some opportunities for AI use? Copyright © 2019 Wolters Kluwer · All Rights Reserved Research Critique Definition: an objective assessment of a study’s strengths and limitations Critiques to inform EBP focus on whether evidence is accurate, believable, and clinically relevant. Careful and objective appraisals of the researcher’s major conceptual and methodologic decisions Critiques of individual studies can be done for a variety of reasons (e.g., for a student assignment, for making decisions about whether or not to publish a manuscript, for EBP purposes) Vary in scope, length, and form, depending on purpose What are some examples of when and why to critique? (ex. for a thesis for your phD) Copyright © 2019 Wolters Kluwer · All Rights Reserved Question Tell whether the following statement is True or False. Research critiques are done to evaluate the strengths and limitations of a study. a. True b. False Copyright © 2019 Wolters Kluwer · All Rights Reserved Answer a. True Rationale: Although there are a wide variety of reasons for critiquing research, research critiques provide careful and objective appraisals of the strengths and limitations of a study. Copyright © 2019 Wolters Kluwer · All Rights Reserved Key Research Challenges Designing studies to support inferences that are: – Reliable and valid (quantitative studies) – Trustworthy (qualitative studies) – An inference is a conclusion drawn from the study evidence using logical reasoning and taking into account the methods used to generate that evidence. Copyright © 2019 Wolters Kluwer · All Rights Reserved Criteria for Evaluating Quantitative Research (Scientific Merit) Reliability – The accuracy and consistency of obtained information – Most often associated with the methods used to measure variables – Ex. A scale that measures the client’s weight at 150lbs then a moment later it reads 160lbs is not reliable. Reliability refers to the accuracy and consistency of information obtained in a study. The term is most often associated with the methods used to measure variables. For example, if a thermometer measured a patient’s temperature as 371°C 1 minute and as 39.5°C the next minute, the thermometer would be unreliable. Copyright © 2019 Wolters Kluwer · All Rights Reserved Criteria for Evaluating Quantitative Research (Scientific Merit) Validity – The soundness of the evidence—whether findings are convincing, are well-grounded, and support the desired inferences – Question whether the methods are really measuring the concepts that they claim to measure – Is a scale to assess depression really assessing depression or are we really getting an assessment of anxiety or social isolation? Validity is a more complex concept that broadly concerns the soundness of the study’s evidence. Like reliability, validity is an important criterion for evaluating methods to measure variables. In this context, the validity question is whether the methods are really measuring the concepts that they claim to measure. Is a paper-and-pencil measure of depression really measuring depression? Or is it measuring something else, such as loneliness or stress? Researchers strive for solid conceptual definitions of research variables and valid methods to operationalize them. Copyright © 2019 Wolters Kluwer · All Rights Reserved  Phrenology Research How would you judge the reliability and validity of the (very, very fake) pseudoscience of phrenology? -the measured bumps and divides on the head to determine intellect and other aspect related to the human brain (require reliability and validity for research) Copyright © 2019 Wolters Kluwer · All Rights Reserved Evaluative Criteria in Qualitative Studies Trustworthiness - The degree of confidence qualitative researchers have in their data and analyses, most often assessed using the criteria of credibility, transferability, dependability, confirmability, and authenticity. Credibility—a key criterion, achieved to the extent that researchers can engender confidence in the truth of the data and their interpretations Confirmability Dependability Transferability Authenticity Copyright © 2019 Wolters Kluwer · All Rights Reserved Evaluative Criteria in Qualitative Studies – Confirmability - referring to the objectivity or neutrality of the data and interpretations. – Dependability - referring to the stability of data over time and over conditions; analogous to reliability in quantitative research. – Transferability - The extent to which qualitative findings can be transferred to other settings or groups; analogous to generalizability. (ex. Can I say that the finding are generalizable to greater Populus) – Authenticity - The extent to which qualitative researchers fairly and faithfully show a range of different realities in the collection, analysis, and interpretation of their data. Copyright © 2019 Wolters Kluwer · All Rights Reserved Triangulation Triangulation is the use of multiple sources or referents to draw conclusions about what constitutes the truth. (navigational term: where the two ideas or more intersect is very the point of truth exists) – Triangulation can contribute to credibility. – Triangulation is a useful strategy in both qualitative and quantitative research. Copyright © 2019 Wolters Kluwer · All Rights Reserved Question What component is a key aspect of trustworthiness? a. Triangulation b. Reliability c. Credibility d. Validity Copyright © 2019 Wolters Kluwer · All Rights Reserved Answer c. Credibility Rationale: Credibility is a key criterion for trustworthiness. Reliability and validity are key for evaluating quantitative research. Triangulation is the use of multiple sources or referents to draw conclusions. Copyright © 2019 Wolters Kluwer · All Rights Reserved Bias (MAJOR CHALLENGE) A distortion or influence that results in an error in inference Examples of factors creating bias o Lack of participants’ candor (inadvertently hold back information or lie) o Faulty methods of data collection (use a tool that’s may be reliable for is not valid for what research trying to studied) o Researcher’s preconceptions (ex. Unconscious biases; pharmacological study where we really want a drug to work for the clinical trial by changing or altering results) o Participants’ awareness of being in a special study (ex. placebo effect) o Faulty study design (if I just make a bad study, then data is irrelevant) Copyright © 2019 Wolters Kluwer · All Rights Reserved Research Control In quantitative studies, research control involves holding constant extraneous factors (confounding variables) that influence the dependent variable to better understand relationships between the independent and dependent variables. (ex of confounding variables: in clinical study would be other medical conditions other then the one being researched)- is the thing I am changing the only thing that will cause a change in the dependent variable Research control is one method of addressing bias. Copyright © 2019 Wolters Kluwer · All Rights Reserved Bias Reduction: Randomness and Blinding Randomness—allowing certain aspects of the study to be left to chance rather than to researcher or participant choice – An important tool for achieving control over confounding variables and for avoiding bias Blinding (or masking), which is used in some quantitative studies to prevent biases stemming from people’s awareness – Blinding involves concealing information from participants, data collectors, or care providers to enhance objectivity. (Gold standard of double blinded studies, although not always possible to achieve this) Copyright © 2019 Wolters Kluwer · All Rights Reserved Reflexivity The process of reflecting critically on the self and of attending to personal values that could affect data collection and interpretations of the data Qualitative researchers are trained to explore these issues, to be reflective about decisions made during the inquiry, and to record their thoughts in personal diaries and memos. Reflexivity can be a useful tool in quantitative as well as qualitative research—self awareness and introspection can enhance the quality of any study. Copyright © 2019 Wolters Kluwer · All Rights Reserved Question Tell whether the following statement is True or False. Blinding is used in qualitative studies. a. True b. False Copyright © 2019 Wolters Kluwer · All Rights Reserved Answer b. False Rationale: Blinding is used in quantitative studies to reduce bias that results from awareness. Copyright © 2019 Wolters Kluwer · All Rights Reserved Generalizability and Transferability Generalizability: the criterion used in quantitative studies to assess the extent to which the findings can be applied to other groups and settings (huge area of important especially related to health care; not very easily done related to gender/culture and other aspects of a human Populus) (this is a large problem related to Generative AI in regard to a healthcare setting, AI is only as good as the data it has access to) Transferability (the equivalent to generalizability in a qualitative research): the extent to which qualitative findings can be transferred to other settings An important mechanism for promoting transferability is the amount of rich descriptive information qualitative researchers provide about study contexts. Copyright © 2019 Wolters Kluwer · All Rights Reserved Time for a Break! Copyright © 2019 Wolters Kluwer · All Rights Reserved  Chapter 7 Finding and Reviewing Research Evidence in the Literature Purposes of a Literature Review Integrate research evidence to sum up what is known and not known (More importantly) Communicate the state of evidence to others Lay the foundation for new studies Help researchers interpret their findings Copyright © 2019 Wolters Kluwer · All Rights Reserved Types of Information for a Research Review Principal reliance on primary sources (the actual research reports written by researchers who conducted the study) Less reliance on secondary sources (summaries of studies by others) Peripheral use of clinical anecdotes, opinion articles, and case reports may broaden understanding of a problem or demonstrate a need for research. Copyright © 2019 Wolters Kluwer · All Rights Reserved Flow of Tasks in a Literature Review Copyright © 2019 Wolters Kluwer · All Rights Reserved Question Tell whether the following statement is True or False. Researchers should rely heavily on secondary sources for information. a. True b. False Copyright © 2019 Wolters Kluwer · All Rights Reserved Answer b. False Rationale: Researchers need to rely principally on primary sources (actual research reports written by those who conducted the study) for information. Secondary sources should not be considered substitutes for primary sources because secondary sources are not sufficiently detailed and may not be completely objective. Copyright © 2019 Wolters Kluwer · All Rights Reserved Developing a Search Strategy Search bibliographic databases via a computer. Use the ancestry approach (“footnote chasing”). – Use the bibliography of a recent relevant reference to find earlier related studies (ancestors). Use the descendancy approach. – Use a pivotal early study in citation indexes to find later studies (descendants) that cite the pivotal study. Copyright © 2019 Wolters Kluwer · All Rights Reserved Starting an Electronic Search Most electronic searches start with a search for substantive topics, initiated by entering keywords. Keywords do not have to be the same as the subject headings in the database because most search programs have mapping capabilities. For quantitative studies, the keywords are typically the independent and dependent variables and, often, the population. For qualitative studies, the keywords are the central phenomenon of interest and the population. Copyright © 2019 Wolters Kluwer · All Rights Reserved Types of Search in Electronic Databases Subject search—search for topics or keywords in the database Textword search—search for specific words (which can be keywords) in text fields of the database record (e.g., in the abstract or title) Author search—search for prominent researchers in a field Copyright © 2019 Wolters Kluwer · All Rights Reserved Tools for Searching: Wildcard Characters Can extend a search to multiple words with the same root, by adding the database’s wildcard character to a truncated word – A truncation symbol (often an asterisk, *) expands a search term to include all forms of a root. – Example: nurs* would search for nurse, nurses, nursing Different databases or software packages use different wildcards, such as * or $. Copyright © 2019 Wolters Kluwer · All Rights Reserved Question When beginning a search for relevant evidence, the researcher uses the bibliography of a recent relevant reference to find studies. This method is called: a. Descendancy approach b. Keyword searching c. Ancestry approach d. Use of wildcards Copyright © 2019 Wolters Kluwer · All Rights Reserved Answer c. Ancestry approach Rationale: The ancestry approach, also called “footnote chasing,” involves the use of a bibliography in a recent and relevant reference to find earlier related studies. The descendancy approach uses a pivotal early study in citation indexes to find later studies. Keyword searching involves a search using words for the substantive topics. Wildcard characters use a truncated word with the database’s approved character. Copyright © 2019 Wolters Kluwer · All Rights Reserved Tools for Searching: Boolean Operators Boolean operators: can be used to combine, restrict, or broaden searches – AND: instructs computer to retrieve references in which two or more terms are present (e.g., obesity AND diabetes). – OR: instructs computer to retrieve references containing any of 2+ terms separated by “OR” (e.g., obesity OR diabetes). – NOT: narrows a search by retrieving information for one term, not the other Copyright © 2019 Wolters Kluwer · All Rights Reserved Tools for Searching: Quotation Marks Yields citations in which the exact phrase appears in text fields The use of quotation marks around a phrase can change the search results. – For example, a search for “high blood pressure” would yield overlapping but nonidentical results to high blood pressure. Copyright © 2019 Wolters Kluwer · All Rights Reserved Key Databases for Nurse Researchers CINAHL (Cumulative Index to Nursing and Allied Health Literature) – It covers references to hundreds of nursing and allied health journals as well as to books and dissertations. MEDLINE (Medical Literature On-Line) – The premier source for bibliographic coverage of the biomedical literature. Copyright © 2019 Wolters Kluwer · All Rights Reserved CINAHL Covers nursing and allied health literature from 1982 to present Contains citations, abstracts (for most entries), and names of any data collection instruments Can be searched through a commercial vendor (e.g., OVID) or directly through www.cinahl.com Copyright © 2019 Wolters Kluwer · All Rights Reserved Example of a CINAHL Reference Critical Care Nursing Quarterly, 2008 Jan–Mar 31 (1): 35–47 (17 ref) Critical Care Name of journal that Nursing Quarterly : published the study 2008 : Year of publication Jan–Mar : Month of publication 31 : Volume (1) : Issue 35–47 : Pages (17 ref) : Number of references Copyright © 2019 Wolters Kluwer · All Rights Reserved Question Tell whether the following statement is True or False. The nurse researcher can use CINAHL to search for relevant information published in 1975. a. True b. False Copyright © 2019 Wolters Kluwer · All Rights Reserved Answer b. False Rationale: CINAHL covers nursing and allied health literature from 1982 to present. Copyright © 2019 Wolters Kluwer · All Rights Reserved MEDLINE Developed by the U.S. National Library of Medicine Covers about 5,600 nursing, biomedical, and health journals and has more than 24 million records Can be accessed for free anywhere in the world via PubMed Uses a controlled vocabulary called MeSH (Medical Subject Headings) to index entries Copyright © 2019 Wolters Kluwer · All Rights Reserved Google Scholar It is a popular bibliographic search engine that was launched in 2004 and includes articles in journals from scholarly publishers in all disciplines and books, technical reports, and other documents. One advantage of GS is that it is accessible free of charge over the Internet. It allows users to search by topic, by a title, and by author and uses Boolean operators and other search conventions. Copyright © 2019 Wolters Kluwer · All Rights Reserved Screening, Documentation, and Abstracting After identifying potentially relevant citations, the references must be: – Screened and gathered (best to work with a copy of the article) – Documented—note search actions and results (documentation of the research, key term and results found; also noting the amount relevant to this portion) – Abstracted and recorded—notes are made of key pieces of information (e.g., using a literature review protocol). Copyright © 2019 Wolters Kluwer · All Rights Reserved Evaluating and Analyzing the Evidence Integrating and synthesizing information across studies for a research literature review have much in common with a qualitative analysis. In both, the focus is on identification of important themes. Copyright © 2019 Wolters Kluwer · All Rights Reserved Analyzing the Evidence in a Literature Review A variety of themes (patterns) can be pursued. Substantive themes are likely to be especially important: – What is the pattern of evidence? – What findings predominate? – How much evidence is there? – How consistent is the body of evidence? – What are key gaps in the body of evidence? Copyright © 2019 Wolters Kluwer · All Rights Reserved Analyzing the Evidence in a Literature Review—(cont.) Methodologic themes – What methods have been used to address the question? – What are major methodologic deficiencies and strengths? Generalizability themes – To what populations does the evidence apply? – Do the findings vary for different types of people? Copyright © 2019 Wolters Kluwer · All Rights Reserved Critiquing Articles Copyright © 2019 Wolters Kluwer · All Rights Reserved PICO QUESTION DEVELOPMENT P= Patient/ Population/Participant I = Intervention/ Interest /Issue C = Comparator/ Control / Contrast O = Outcome T= Time Copyright © 2019 Wolters Kluwer · All Rights Reserved