Topic 3 Finding Research Literature PDF

learning outcomes • By the end of this topic students should be able to Summarize how a literature review for a scholarly study in the discipline of rehabilitation is conducted in relation to: - The steps in the overall process. The types of databases often searched. The criteria for evaluating the...

learning outcomes • By the end of this topic students should be able to Summarize how a literature review for a scholarly study in the discipline of rehabilitation is conducted in relation to: - The steps in the overall process. The types of databases often searched. The criteria for evaluating the quality of a study. The ways of organizing the material found. Use UJ electronic library services to find scientific evidence to support clinical approaches used in rehabilitation. 1 Finding Research literature Chapter four • • • • • • • • • Reasons for searching the literature Types of information Types of professional literature Finding literature Some common rehabilitation databases Library catalogs Reference lists and bibliographies Single journal indexes or databases Organising your search 2 Library catalogs • Index only the holdings of a particular library. • One of the advantages is that researchers will know that materials will be readily available. • Materials in all media will be represented including film and sound catalog. 3 BASIS FOR COMPARISON REFERENCE BIBLIOGRAPHY Meaning Reference implies the list of sources, that has been referred in the research work. Bibliography is about listing out all the materials which has been consulted during the research work. Arrangement Alphabetically and numerically Alphabetically Includes Only in-text citations, that have been used in the assignment or project. Both in-text citations and other sources, that are used to generate the idea. Supporting argument A reference can be used to support an argument. A bibliography cannot be used to support an argument. 7 Reference lists and bibliographies • Limitation (especially book chapters) no sources listed can be more recent than the list. • Advantage- all cited work will be relevant to the article or chapter. • Another advantage is that the researcher will save time as locating the sources will be fast and easy. 8 Single journal indexes or databases • Subscription to journals will mean that researchers would have access in their own libraries. • Many journal publish an annual index of the authors and topics. • Many journals maintain websites with searchable databases. 9 • It is recommended that you start with internet-based database 1. Define the information needed 2. Break the information needed into components 3. Identify synonyms for each concept or component (key word search) 4. Construct logical relationships among the concepts using the terms “AND” “OR” “NOT” 12 Answer the following questions (cont.) 5. Which variable did you use in your search? (language or year of publication). 6.Which data base(s) did you use in your search? 7.Which journal or textbook did you consult in your search? 16 Assignment (cont.) • The assignment will be out of 20 total possible marks. • You should type your answers in English and specify the answer to each question. • You should finish the assignment individually. • Deadline: Saturday 14/10/2023 (12 midnight). 17 Assignment (cont.) How do I search Google effectively? Part I: Boolean Operators & Phrase Searching • https://www.youtube.com/watch?v=Yj2YAg1Z Rmg 18 Research fundamentals topics • The first part of the module will be introducing you to the fundamentals of research and will include the following topics Research ethics 1 learning outcomes • By the end of this topic student should be able to - Appraise principles of research ethics followed when conducting Communication Disorders research. - Debate (within discussions and forums) ethical procedures, study designs, and sampling techniques used in different studies using appropriate language and format. 2 Research risks • • • • Physical risk Psychological risk Social risk Economic risks 3 Physical risk • In the event of a strengthening study the aim of the study is to provide electrical stimulation to swallowing musculature Discuss • is it ethical to perform? • If no, justify? • If yes, What should the participants know about the potential risk? 4 Physical risk • If the study is evaluating an invasive muscle electromyography Discuss • is it ethical to perform? • If no, justify? • If yes, What should the participants know about the potential risk? 5 Physical risk • The impact of NOT receiving a treatment Discuss is it ethical to perform? If no, justify? If yes, What should the participants know about the potential risk? 6 Physical risks (1) when there is no proven effective treatment for the condition under study (2) when withholding treatment poses negligible risks to participants (3) when there are compelling methodological reasons for using placebo, and withholding treatment does not pose a risk of serious harm to participants more controversially, (4) when there are compelling methodological reasons for using placebo, and the research is intended to develop interventions that can be implemented in the population from which trial participants are drawn, and the trial does not require participants to forgo treatment they would otherwise receive. 7 Condition Variants Examples No treatment exists Trial of a new medication to prevent 23 Alzheimer’s dementia Trial tests add-on treatment Trial of a new agent against placebo added to standard chemotherapy 24 for ovarian cancer 1. No proven effective intervention for condition under study. Data on existing treatment cannot Trial to test whether an existing be extrapolated to the population of anti-depressant is efficacious in the 25 interest treatment of PTSD 2. No or negligible harms from delaying or forgoing treatment. Not treating is an acceptable option for the condition under study Trial of medication for male pattern 26 baldness Negative consequences of not receiving treatment are negligible Trial of medication for symptom 27 relief of allergic rhinitis 8 3. Compelling methodological reasons for use of placebo; and Participants are not at risk of excessive harm. 28 High expected placebo response Trial of new analgesic OR Fluctuating outcomes Trial of new treatment for psoriatic 29 arthritis AND Mixed data on effectiveness of standard treatment Trial of new anti-depressant 30 Short course AZT for prevention of 31 mother to child HIV transmission 4. Compelling methodological reasons for use of placebo; and Participants are not deprived of interventions they would otherwise receive; and Research intended to develop interventions that will benefit the host population. Trial of rectal artesunate as initial treatment for severe malaria 32 patients en route to referral clinics 9 Psychological risks • Can you think of examples where psychological risk can occur in Communication Disorders research? 10 Psychological risks • • • • Inclusion criteria Methodology Type of experiment Research-participant interactions 11 Social risks • Breach of confidentiality 12 Economic risks • Can you think of ways that the participant could be affected with economic risk? 13 • Research Paradigms 2 Chapter Outline Quantitative Paradigm & Qualitative Paradigm Assumptions Methods • • • • • Theory Selection Measurement Manipulation Control 3 Definition • “Our beliefs about the methods of obtaining knowledge constitute research paradigm.” Carter & Lubinsky (p.55) • The beliefs and thoughts the researcher has about the meaning or interpretation of research data. 4 Research Approaches in Rehabilitation What is a research paradigm? (video What is a paradigm?). • Most dominant in Rehabilitation research: – Quantitative paradigm. • Less commonly used: – Qualitative research. – Single-subject paradigms. 5 Alternative Names for the Paradigms Quantitative Qualitative Positivist Naturalistic Received review Phenomenological Logical positivist Ethnographic Nomothetic Idiographic Empiricist Postpositivist New paradigm Single-Subject Idiographic N=1 Single system 6 Quantitative Paradigm • Quantitative: refers to the measurements that characterize the paradigm. • Focus on being certain or positive of knowledge that can be verified through measurement and observation. • Known as the traditional method of science 7 Assumptions of the Quantitative Paradigm 1. 2. 3. Assumption Single objective reality Main points Independence of investigator and subjects Generalizability of results Investigator and object of inquiry can be independent of one another. (e.g., “Clever Hans”). Goal is to develop results that can be generalized to reality. There is a single objective reality: 1. Determine its nature through measurement and observation of phenomena of interest. 2. Predict or control reality. 8 Assumptions of the Quantitative Paradigm (cont.) 4. Assumption Determining causation Main points Cause and effect can be determined and differentiated from one another through manipulation and control of IVs and DVs. 5. Value free The nature of this paradigm eliminates the influence and opinions of the investigator and society from affecting the facts that are observed. 9 Qualitative Paradigm • “ …. humans cannot be studied as isolated units but must be understood in the context of their "lived world" or cultural and social connections.” https://nursing.utah.edu/research/qualitative-research/what-is-qualitativeresearch.php 10 Qualitative Paradigm (cont.) Goal: • “Qualitative research seeks to understand a given research problem or topic from the perspectives of the local population it involves. Qualitative research is especially effective in obtaining culturally specific information about the values, opinions, behaviors, and social contexts of particular populations.” https://course.ccs.neu.edu/is4800sp12/resources/qualmethods.pdf 11 Assumptions of the Qualitative Paradigm 1. 2. 3. Assumption Multiple constructed realities Main points There are always several versions of reality in which the meaning of events is attached by the participants. Independence of investigator and subjects Investigator and subject and interdependent: the process of inquiry changes both the investigator and the subject. Results specific to Idiographic: pertains to a particular time and context time and context. 12 Assumptions of the Qualitative Paradigm Assumption 4. No causation 5. Value laden Main points It is impossible to distinguish between cause and effect. All research is influenced by the values of the scientists who conduct research and the sources that fund research. 13 Single-Subject Paradigm • “ The single-subject paradigm developed out of a concern that the use of traditional group research methods focused away from the unit of clinical interest: the individual.” Carter et al. p63 Single-subject research eliminates the group conclusion and focuses on treatment effects for individuals. 14 Example • Group design • Aim of study: examine the effectiveness of a particular gait-training technique on gait velocity. • Participants: 30 patients who have undergone transtibial amputation. 15 Example (cont.) Pretreatment average gait speed= .5 m/s Gait velocity Post training speed Outcome What is the indication for group? for individual participants? 16 Example (cont.) What is the indication for group? for individual participants? • Single-subject research eliminates the group conclusion and focuses on treatment effects for individuals. 17 Assumptions of the SingleSubject Paradigm 1. 2. Assumption Environmental stimuli effect on treatment Main points The effectiveness of treatment is subject and setting dependent. The nature of practice is idiographic Focus of study is individuals rather than groups. 18 Assumptions of the SingleSubject Paradigm 3. 4. 5. Assumption Single objective reality Main points Independence of investigator and subjects Generalizability of results Investigator and object of inquiry can be independent of one another. There is a single objective reality: 1. Determine its nature through measurement and observation of phenomena of interest. 2. Predict or control reality. Goal is to develop results that can be generalized to reality. 19 Assumptions of the SingleSubject Paradigm (cont.) 6. Assumption Determining causation Main points Cause and effect can be determined and differentiated from one another through manipulation and control of IVs and DVs. 7. Value free The nature of this paradigm eliminates the influence and opinions of the investigator and society from affecting the facts that are observed. ** Assumptions 3-7 are similar to the assumptions of the quantitative paradigm 20 Methods of the Three Research Paradigms 21 "Grounded theory refers to a set of systematic inductive methods for conducting qualitative research aimed toward theory development. The term grounded theory denotes dual referents: (a) a method consisting of flexible methodological strategies and (b) the products of this type of inquiry. Increasingly, researchers use the term to mean the methods of inquiry for collecting and, in particular, analysing data.” https://guides.temple.edu/groundedtheory Relationships Among the Research Paradigms Depend on the beliefs of the researchers. • Some believe that adopting the assumptions of one paradigm means abandoning the assumptions of the others. • Other researchers believe that the assumptions of the paradigms are relative and do not need to be applied to every situation (are applied when appropriate to a given research problem). 23 Moderate View of the Relationships • The paradigms can be mixed within a study to address different aspects of a research problem. 24 Example: • Study: Impact of child and family characteristics on sibling relationships of deaf children. • Paradigm used: – Qualitative: parent interviews about the quality of sibling relationships. – Quantitative: Use of a scale to search for factors that could explain differences in sibling relationships in different families. 25 Advantages and Disadvantages of Using A Research Paradigm • What are the advantages and disadvantages of using qualitative research methods? • What are the advantages and disadvantages of using quantitative research methods? – Video: Quantitative vs Qualitative Research (Video 2) 26 Research Methods in Communication Disorders: Main sections Research fundamentals Research design Communication Disorders research Research paradigm Evidence-based practice Research validity Finding research literature Selection and assignment of participants Research ethics Evaluating evidence Experimental & nonexperimental designs Group designs Variables Article critique Research beyond everyday Qualitative research Nonexperimental research 2 Communication Disorders research Topic outline: • Definition and characteristics of scientific research. • Reasons for developing Communication Disorders research. • Barriers to Communication Disorders research. • The scientist-practitioner. • The status of Communication Disorders research. 3 Student Learning Outcomes (SLOs) By the end of this topic, the student should be able to: A. Formulate systematic literature reviews online, such as through MEDLINE, PUBMED and other relevant databases. B. Explain the meaning of evidence-based practice, its significance, criteria, advantages, and limitations. 4 D. Identify the 7 key components of a research article (literature review, rationale, purpose, methodology, results, discussion and conclusion). E. Evaluate the 7 key components of a research article (literature review, rationale, purpose, methodology, results, discussion and conclusion). 5 SLOs (cont.) F. Discuss research concepts using scientific terminology. G. Develop a problem of significance to the profession of Speech-Language Pathology. 6 Definitions of research “The study of mechanisms and interventions that prevent, improve, restore or replace lost, underdeveloped or deteriorating function, where "Function" is defined at the level of impairment, activity and participation according to the WHO-ICF Model.” 7 Research characteristics • Challenges the status quo (current state) – Identify gaps in knowledge: identify common practices which we know little about. – Systematic evaluation of the effects of Communication Disorders practices about which few data exist. – Test novel or traditionally avoided treatment • Research is creative – “why?” “why not?” “what if?” • Research is systematic – Systematic description of a phenomenon of interest. Isolate treatment effects from influences that not ordinarily controlled in the clinic setting. 8 Reasons for developing Communication Disorders research • Develop body of knowledge • Determine whether interventions work • Improve patient and client care 9 Reasons for developing Communication Disorders research (cont.) • Develop body of knowledge Conceptual performance, collective identity 10 Reasons for developing Communication Disorders research (cont.) • Determine whether interventions work “evaluate effectiveness of existing interventions and to develop novel approaches of care” BrummelSmith 11 Reasons for developing Communication Disorders research (cont.) • Improve patient and client care – knowing what is proved or not by research will enable the clinician to make intelligent, evidence based decision about which clinical procedure to use with the client. 12 Lack of funds The clinical researcher dichotomy Ethical concern about use of human participants and animal subjects Lack of research mentors Barriers of Communication Disorders research Lack of time Lack of statistical support Lack of familiarity with the research process 13 Barriers to Communication Disorders research (cont.) • • • • • • Lack of funds Lack of research mentors Lack of time Lack of familiarity with the research process Lack of statistical support Ethical concern about use of human participants and animal subjects • The clinical researcher dichotomy 14 Overcoming barriers • Leaders who are committed (time, money, effort) • Devoted individuals • Develop productive research teams 15 The scientist- practitioner • This model was developed in clinical psychology and later applied in Communication Disorders professions. • The model seeks to provide education to clinicians so that they have good research skills and researchers have good clinical training at least to the extent of good understanding. 16 Status of Communication Disorders research • Professional association goals - The mission of professional associations is to promote the ability of Communication Disorders professions to take a leading role in research. - Common program requirement for accreditation. • Research publication vehicles - Dissemination of Communication Disorders research findings in peer reviewed journals (Journal of Voice, JSLHR, Communication Disorders). 17 Status of Communication Disorders research (cont.) • Educational standards - Reflect the emphasis of research in the emphasis by which standards are evaluated. • Research funding - National Institute for Health conduct and support research through many specialised institutes focusing on particular branches of medicine and health care. - Private foundation associated with rehabilitation professions provide sources for funding. 18 The need or demand • The ethical principles of beneficence and nonmaleficence (obligation of no harm) demand that health professionals use the best practice available (based on research) without inflicting harm. • Patients as consumers have been increasingly given the responsibility in determining their own health. 4 Note for US: Great source of info and video! • https://libraryguides.nau.edu/c.php?g=66592 7&p=5074952 5 The need or demand (cont.) • Patients demand that their practitioners use the most effective interventions for faster and more cost-effective recovery. • Third-party payer demands that health care providers use the most cost-effective interventions. 6 What is evidence-based practice? • “Integration of the best research evidence with clinical expertise and patient values” based on evidence-based medicine (EBM) model. • EBM considers the following major aspects: 1. Research evidence 2. Clinical observation 3. Patient reports 7 What is evidence-based practice? (cont.) • Evidence can vary in its validity • The EBM model developed a hierarchy of evidence to assist physicians in determining the validity of published studies. • The gold standard of the EBM hierarchy model is the randomized control trial (RCT) • The hierarchy considers quantitative studies to be stronger than qualitative studies and multiple studies to be stronger than single studies assuming equality of studies. 8 What is evidence-based practice? (cont.) • Five domains of medical practice and research 1. Therapy/prevention/harm/etiology 2. Prognosis 3. Diagnosis 4. Differential diagnosis/symptom prevalence 5. Economic and decision analysis 9 EBM hierarchy • For each of these domains there are five main levels of evidence For the first level (highest level of evidence) 1a. Systematic reviews and meta-analysis of randomized control trial RCT 1b. Single RCT studies 1c. All or none study 10 EBM hierarchy (cont.) The second level in the hierarchy is the cohort studies 2a. Systematic review of the cohort study 2b. Individual cohort study or low quality RCT 2c. Outcomes research studies and ecological studies 11 EBM hierarchy (cont.) The third level is divided to two sublevels 3a. Systematic review (with homogeneity) of case controlled studies 3b. Individual case control studies The fourth level is case series and poor quality cohort and case- control studies The fifth level is expert opinion without explicit critical appraisal 12 RCTs randomized control trial • RCTs are given the highest level because they are designed to be unbiased and have less risk of systematic errors –Burns et al 2012 13 14 Evidence-based practice process 15 Evidence-based practice process (cont.) • Four considerations are taken in formulating the patient care question 1. Patient characteristics 2. The intervention 3. The comparative intervention 4. Outcomes - These are represented by the acronym PICO (population, intervention, control, and outcomes) 16 PICO Formula P I • Patient, population or problem: What are the most important characteristics of the patient and their health status • Intervention/Issue: What main intervention are you considering? C • Comparison/alternative: What are the alternative benchmark or gold standards being considered? O • Outcome: What is the estimated likelihood of a clinical outcome attributable to a specific disorder? Framework of asking different types of PICO questions Etiology Are P Who I compared with those who C at greater risk for developing O ? Prediction For P , how does I compared with C predict/influence future O ? Prevention In p , is I better than C in preventing O ? Diagnosis When assessing P , is I more accurate than C for diagnosing O ? Intervention When working with P , Does I or C result in better O ? Management Do P who receive I compared with C report greater or fewer O ?