UNIT 4 - KNOWLEDGE, DOCUMENTATION AND SCIENTIFIC RESEARCH PDF

ITEM IV: Knowledge, research and scientific documentation Foundations of Physiotherapy D. Pedro Vega Moreu Sports and Invasive Physiotherapy Specialist [email protected] ITEM 4: KNOWLEDGE, RESEARCH ADN SCIENTIFIC DOCUMENTATION THE CONCEPT OF RESEARCH • Scientific Research • Science • Scien...

ITEM IV: Knowledge, research and scientific documentation Foundations of Physiotherapy D. Pedro Vega Moreu Sports and Invasive Physiotherapy Specialist [email protected] ITEM 4: KNOWLEDGE, RESEARCH ADN SCIENTIFIC DOCUMENTATION THE CONCEPT OF RESEARCH • Scientific Research • Science • Scientific Knowledge • Purposes • Scientific Method STUDY DESIGNS SCIENTIFIC DOCUMENTATION • Classification criteria: • Purpose • Temporal Sequence • Control of the assignment of study factors • Begining of the research in relation with the study facts • DESIGN: •Experimental • quasiexperimental • Non experimental ETICHS IN S.R. INDEX 1. CONCEPT OF RESEARCH 2. STUDY DESIGNS 2.1. CONTROL OF THE ASSINGMENT OF STUDY FACTORS 3. SCIENTIFIC DOCUMENTATION SCIENCE Science OBSERVATION + IDENTIFICATION + THEORETICAL EXPLANATION + DESCRIPTION + EXPERIMENTAL INVESTIGATION = PHENOMENA 17th century 5 THE CONCEPT OF RESEARCH • SCIENCE ➢ Principle of Knowability: • It states that the reality is knowable • Essential element for the existence of Science • Otherwise, science would not exist THE CONCEPT OF RESEARCH • SCIENCE ➢ Principle of Determinism: • Every phenomenon is strictly determined by their circumstances, external and internal. Principle of Causality: • Nothing happens without a cause. RESEARCH 8 THE CONCEPT OF RESEARCH • RESEARCH/ INVESTIGATION ➢ ➢ Discover or find something, explore. ➢ Researcher: Person engaged in any search activity, regardless of its method, purpose, and importance THE CONCEPT OF RESEARCH • SCIENTIFIC RESEARCH "The activity by which we acquire new empirical knowledge by employing the Scientific Method to make new contributions to Science“ KNOWLEDGE THE CONCEPT OF RESEARCH • TYPES OF KNOWLEDGE ➢ Scientific ➢ Common Sense ➢ Experience ➢ Logical Reasoning THE CONCEPT OF RESEARCH The Scientific Knowledge (7 FEATURES) "Aspects of knowledge, as objective as possible, referring to the reality in which we exist" • Directly linked to scientific research • Developed and accepted THE CONCEPT OF RESEARCH SCIENTIFIC KNOWLEDGE FEATURES 1. Rationality (rational): • Generate theories or laws of universe/nature/man using reason. 2. Factual: • Originated from empirical data (facts or phenomena of reality) • Objectified, measurable THE CONCEPT OF RESEARCH SCIENTIFIC KNOWLEDGE FEATURES 3. Objectivity (target): • Their findings are the result of the direct interpretation of results without subjective components of the researcher 4. Testability (testable): • Replicable: to be repeated more or less similar conclusions • Reliability of scientific knowledge THE CONCEPT OF RESEARCH SCIENTIFIC KNOWLEDGE FEATURES 5. Methodical (Systematic): • It is not the result of improvisation; rigorous, systematic and carefully designed methodology 6. Analytical: • The reality is interpreted from simple elements (easily affordable and controllable) THE CONCEPT OF RESEARCH SCIENTIFIC KNOWLEDGE FEATURES 7. Communicable: • Precise language accepted by the scientific community • (No persuasive) informative language TAKE HOME MESSAGES! • Basic concepts to start with: SCIENCE - RESEARCH KNOWLEDGE • SCIENTIFIC KNOWLEDGE : 7 CONCEPTS • RESEARCH + SCIENCE = DAILY LIFE!!! 18 INDEX 1. CONCEPT OF RESEARCH 2. STUDY DESIGNS Scientific Method Purposes of scientific research 2.1. CONTROL OF THE ASSINGMENT OF STUDY FACTORS 3. SCIENTIFIC DOCUMENTATION • THE SCIENTIFIC METHOD Conceptual stage Research Question  Literature review  Framework  Objectives and hypotheses Methodological stage Research design (methodology)  Study Subjects  Variables  Collection techniques and data analysis  Material and Methods Empirical stage     Data Collection Analysis Interpretation of results Communication THE CONCEPT OF RESEARCH INVESTIGATION: RELATIONSHIP BETWEEN VIOLENT CARTOONS AND AGGRESSIVENESS IN CHILDHOOD CONCEPTUAL PHASE Literature -  - - review Databases. Books. Webpages Framework Articles Statistics Reviews Objectives and hypotheses - Cause-effect relation - How many hours? - Age?  DESIGN PHASE Study Subjects - Kids from 4 to 15 years old - Both genders - Differente socio-economic levels - Spain  Variables - Agresiveness - Hours - Gender - …  Collection techniques and data analysis - Questionnaire (STAI-C, YSR…). - Experts opinión (psychologists…) - Police statistics  CONTROL GROUP EXPERIMENTAL GROUP Material and Methods - 1 year following - 2 hours TV/DAY – 4 hours TV/DAY – 0.5 hours TV/DAY - AMERICAN / JAPANESE CARTOONS - PHYSICAL ACTIVITY PRE/AFTER/0.  DESIGN PHASE EMPIRICAL PHASE Start protocol - Begin intervention - Exposition = different groups Data Collection - Give questionnaires - Experts interviews - Police statistics over research time ANALYTICAL PHASE Analysis - Statistical Analysis (Wilcoxon, χ², …) - Comparation - Numbers!.  Interpretation of results - Conclusion= more numbers - Discussion (we add our point of view in relation with framework)  DIFFUSION PHASE  - Communication Scientific DATABASES Books University Congress TV, Radio… interviews 28 THE CONCEPT OF RESEARCH PURPOSE OF SCIENTIFIC RESEARCH 1. Description 2. Exploration 3. Explanation 4. Prediction and control THE CONCEPT OF RESEARCH PURPOSE OF SCIENTIFIC RESEARCH DESCRIPTION • Objective: describe process related phenomena • It is observed, described (does not explain or analyze causes) THE CONCEPT OF RESEARCH ➢ DESCRIPTION • Example: A descriptive study of 128 patients suffering from spina bifida. • Objectives: describe predisposing factors • 13.8% family history • 95.5% mothers did not take folic acid THE CONCEPT OF RESEARCH EXPLORATION Objective: explore ways in which a phenomenon occurs and the factors to which it relates Example: Study on preoperative emotional stress • If descriptive: describe the degree of emotional stress, frequency… • Exploratory: What are the factors related to the level of emotional stress? How emotional stress is manifested in patients with different characteristics? THE CONCEPT OF RESEARCH ➢ EXPLANATORY: • Objective: provide explanations. Search for understanding of the underlying causes of the phenomenon studied (CAUSE-EFFECT) Why is it a phenomenon? What are its causes, risk factors? • Example: What determines a high frequency of injuries in football? THE CONCEPT OF RESEARCH ➢ PURPOSE OF SCIENTIFIC RESEARCH ➢ PREDICTION AND CONTROL: • Objectives: to make predictions and control phenomena of which it does not have a full understanding THE CONCEPT OF RESEARCH ➢ PREDICTION AND CONTROL: • Example: The frequency of children born with Down syndrome increases on a par with the age of the mother • Prediction: a mother of 40 years has a higher risk than a mother of 25 years • Control: the result can be controlled: informing mothers; analysis TAKE HOME MESSAGES! • NOW I KNOW THE DIFFERENT STAGES OF THE SCIENTIFIC METHOD – AND WHAT WE DO IN EACH OF THEM. • PURPOSES OF SCIENTIFIC RESEARCH??: YES, I KNOW THEM!. 36 ITEM 4: KNOWLEDGE, RESEARCH ADN SCIENTIFIC DOCUMENTATION THE CONCEPT OF RESEARCH • Scientific Research • Science • Scientific Knowledge • Purposes • Scientific Method STUDY DESIGNS SCIENTIFIC DOCUMENTATION • Classification criteria: • Purpose • Temporal Sequence • Control of the assignment of study factors • Begining of the research in relation with the study facts • DESIGN: •Experimental • quasiexperimental • Non experimental ETICHS IN S.R. INDEX 1. CONCEPT OF RESEARCH 2. STUDY DESIGNS 2.1. CONTROL OF THE ASSINGMENT OF STUDY FACTORS 3. SCIENTIFIC DOCUMENTATION STUDY DESIGNS IN ORIGINAL SCIENTIFIC RESEARCH STUDY DESIGNS Design: • Procedures, methods and techniques by which study subjects are selected, information is collected and analyzed and results are interpreted. Hypothesis RESULTS Final Data Classification criteria: 1. Purpose of the study 2. Temporal sequence 3. Start of the study in relation to the chronology of events 4. Control of assignment of the studied factors 1. Purpose of the study Analytical Evaluates a suspected cause effect relation (etiology, treatment ..) Descriptive Not looking cause effect relationship. Descriptive Prevalence Studies Incidence Studies Cases Serial Ecologist Studies CONCRETE SUBJECTS + CONCRETE MOMENT CONCRETE SUBJECTS + OVER TIME RARE CHARACTERISTIC + OVER TIME + SUBJECTS HAVE SOMETHING IN COMMON GROUP – POPULATION + USUALLY GEOGRAPHIC AREAS 43 EXAMPLES We want to know: Cases Serial Patients with LOW BACK PAIN with associated pelvic floor muscles weakness Actual LOW BACK PAIN patients in La Paz Hospital Prevalence Studies % of patients with LOW BACK PAIN that took a sick leave in each Spain province Ecologist Studies New LOW BACK PAINS patients since August 2017 Incidence Studies 44 Temporal sequence Cross-sectional (Transversal) •The data for each subject represent essentially a point in time Longitudinal •There is a time lag between the different stages of data collection EXAMPLES: Transversal CHILDREN OBESITY – KNEE PAIN - SCHOOL POPULATION -Relation between 2 patologies. - No cause – effect relation= we dont know temporal sequency Knee Pain No Knee pain Obese A B A+B Non obese C D C+D A+C B+D TOTAL Prevalence Reason: (A/(A+B)) / (C/C+D)) “EXPOSED P.R.” “NON EXPOSED P.R.” 46 EXAMPLES: Transversal SCHOOL POPULATION: 325 STUDENTS OBESE: 110 STUDENTS - FROM WICH: 95 WITH KNEE PAIN TOTAL STUDENTS WITH KNEE PAIN: 120 STUDENTS EXPOSED PREVALENCE REASON: 0.86 NON EXPOSED PREVALENCE REASON: 0.11 TOTAL PREVALENCE REASON: 7.818 47 • Start of the study in relation to the chronology of events Prospective: Retrospective •It starts before the studied factors • Data collection as long as results appear Retrospective It starts after the studied factors • Data collection from previous documents or expressed by the subjects 49 EXAMPLES: Prospective - Retrospective We want to know: … if a group of cystic fibrosis patients selfcontrol and selftreat their pathology in a beter way because of the assitance to a physiotherapy educational course last year … attitude of our patients in relation with a physiotherapy educational course to selfcontrol and selftreat cystic fibrosis. We follow them from before the beginning of the course until they are already integrated in it. 50 Control of assignment of the studied factors Experimental • The researcher assigns and controls the study factor with a specified plan • Cause – effect relation (analytical) Control of assignment of the studied factors Observational •The study factor is not assigned by researchers. • There is not direct control of the studied factor • Observe, measure and analyze 52 53 STUDY DESIGNS Example • A researcher selects a sample of 30 hypertensive subjects and give them a prescribed treatment regimen for 12 months to determine how many of them lowered their blood pressure •ANALITYCAL OR DESCRIPTIVE? •EXPERIMENTAL OR OBSERVATIONAL? •TRANSVERSAL OR LONGITUDINAL? •PROSPECTIVE O RETROSPECTIVE? STUDY DESIGNS Example • A study wants to evaluate the usefulness of a biomarker in the diagnosis of a particular type of disease. For this, a sample of patients with this type of disease and other subjects without it are selected. All biomarkers are measured in order to assess whether it is useful or not to distinguish between the two groups •ANALITYCAL OR DESCRIPTIVE? •EXPERIMENTAL OR OBSERVATIONAL? •TRANSVERSAL OR LONGITUDINAL? •PROPECTIVE O RETROSPECTIVE? Smoking and lung cancer DATAS REPRESENT ONE Retrospective POINT IN TIME Analytical ? Descriptive? INTERVENTION Experimental Crosssectional Prospective DATAS FROM A TIME LAG Retrospective Longitudinal Prospective RATS Analytical DATAS REPRESENT ONE POINT IN TIME Crosssectional HOSPITAL DATABASES = 1 TIME Retrospective QUESTIONNAIRE = 1 TIME Prospective Observational DATAS FROM A TIME LAG HOSPITAL DATABASES ALONG THE TIME (PAST DATAS) Retrospective Longitudinal Prospective 56 THE VARIOUS QUESTIONNAIRES ALONG TIME RESEARCH DESIGNS BY ASSIGNMENT CONTROL STUDY OF FACTORS: Experimental, quasi-experimental, NO EXPERIMENTAL Control of assignment of the studied factors Observational Experimental OR Control of assignment of the studied factors Experimental Quasiexperimental Non-experimental 58 TWO MAJOR CONCEPTS: Dependent Variable (DV): variable (quality, characteristic, factor, phenomenon ... ..) that according to the hypothesis depends on another variable or is caused by it. Independent Variable (IV): Variable which presumably is cause of the dependent variable or influences it. DV and IV: IV Example: Hypothesis: Strengthening the transversus abdominis decreases the degree of pain in patients with lumbar disc herniation DV DV and IV: IV Example: • A researcher selects a sample of 30 hypertensive subjects and administered a prescribed oral treatment regimen, followed for 12 months, to determine how many of them lower their blood pressure DV 62 ¡ REMEMBER: Classification criteria! 2. Temporal sequence 1. Purpose of the study Analytical Descriptive 3. Start of the study in relation to the chronology of events Prospective : Crosssectional Longitudinal 4. Control of assignment of the studied factors Experimental Retrospective Observational TAKE HOME MESSAGES! • NOW I CAN IDENTIFY WHAT KIND OS STUDY IM READING. • I CAN DO A TRANSVERSAL DICOTOMIC TABLE!! (SOUNDS NERD ISN´T IT?). • I WILL TRY TO INDENTIFY STUDY DESIGNS ON INTERNET DATABASES. 64 INDEX 1. CONCEPT OF RESEARCH 2. STUDY DESIGNS 2.1. CONTROL OF THE ASSINGMENT OF STUDY FACTORS 3. SCIENTIFIC DOCUMENTATION EXPERIMENTAL + QUASI-EXPERIMENTAL + NON EXPERIMENTAL EXPERIMENTAL RESEARCH PURPOSE: - Establishing a causal relationship between an intervention and the effect observed • For example, estimating the effectiveness of a preventive intervention, curative and rehabilitative Manipulation + Control + Randomness EXPERIMENTAL RESEARCH: MANIPULATION: Supposed to do "something" to a group of subjects: * This "something" is the IV: Treatment, intervention The researcher "manipulates" the IV consciously and observes the effect that manipulation has on the DV "Strengthening the transversus abdominis" EXPERIMENTAL RESEARCH: CONTROL: is exerted by - Preparation of the experimental protocol - Using "control group" EXPERIMENTAL RESEARCH: CONTROL GROUP: - Group of subjects whose behavior regarding VD is used as a basis for evaluating the performance of the same variable in the EXPERIMENTAL GROUP - To obtain scientific evidence of a relationship between variables, is required to perform at least a comparison EXPERIMENTAL RESEARCH: Example - A nutritional complex is administered for two weeks to preterm infants to increase weight - Babies gain weight - Is the treatment has been effective? Is there a causal relationship between nutritional complex (IV) and weight gain (DV)? No, it is normal for children to gain weight as they grow - Need a control group EXPERIMENTAL RESEARCH: RANDOMNESS: randomized - Random distribution of subjects between groups (experimental and control): + Each subject has an equal chance of being assigned to any group - Purpose: subjects from different groups have similar characteristics and they do not influence the results of the investigation RANDOMIZATION 72 EXPERIMENTAL RESEARCH: RANDOMIZED CONTROLLED TRIAL (RCT) Purpose: the IV (treatment) is the only possible cause of observed differences in the results of each group 1 experimental group and one control group Comparable groups of subjects: the only difference is the type of treatment applied (IV) 74 WHAT ABOUT BIAS??? DEFINITION: “..Inclination or prejudice for or against one person or group, especially in a way considered to be unfair…” “…a tendency of an estimate to deviate in one direction from a true value…” ELIMINATE POSSIBLE BIAS IN RELATION TO THE STUDY SUBJECTS!!! 75 EXAMPLE Imagine a new drug for the treatment of multiple sclerosis, which has shown promising results in animal studies and in phase I trials. These results, which suggest that the drug can delay the onset of severe motor compromise, have been widely publicized by the media during the past 3 months. Because of these results, patient advocacy groups are putting pressure on the government to make the new drug available as soon as possible. As multiple sclerosis is a debilitating disease that affects millions of people worldwide and for which there is no known cure, the investigators (all clinicians who have dealt with multiple sclerosis patients for years), the company producing the new drug (which has invested millions in developing the drug), the media (interested in confirming the results that they so widely publicized) and the potential participants (patients with multiple sclerosis who have been waiting for an effective treatment to be discovered) are all interested in demonstrating that the new compound is effective. 76 EXAMPLE After many intense sessions debating the course of action, a multidisciplinary task force created by the government, including consumer representatives, agrees that the next step should be a randomized clinical trial. A research protocol is produced by another multidisciplinary panel of investigators and consumers, and a well known research group at a large health care center is selected to conduct the study. 77 BIAS 1. BEFORE 2. DURING THE STUDY 3. AFTER 78 “BEFORE” BIAS 1. Selection bias Let us suppose that the investigator in charge of recruiting patients for the multiple sclerosis trial (who at least subconsciously hopes that the drug will be found to be effective) thinks that depressed patients are less likely to respond to the new drug. If he has access to the allocation sequence (which has been generated by computer and is locked in his desk) this investigator could introduce bias into the trial by making it more difficult for depressive patients to receive the new drug 2. Choice-of-question bias ‘Don’t do a trial if it won’t show you what you want to find’. 79 “DURING THE STUDY” BIAS 1. Participant ascertainment bias 2. Intervention choice bias 3. Observer bias 4. Co-intervention bias 80 If participants know that they have been allocated to the placebo group, they are likely to feel disappointed and less willing to report improvement at each of the study time points (participant ascertainment bias). Maybe the intervention requires some particular skills, and this aspect give place to the too early – too late – skill related bias (intervention choice bias) Following our example of the multiple sclerosis trial, the new drug may appear to be more effective at the end of the trial if patients allocated to the new drug received physiotherapy earlier and more intensively than patients allocated to placebo (co-intervention bias). In addition, if the people in charge of assessing and recording the outcomes know which patients are allocated to each of the study groups, they could, consciously or unconsciously, tend to record the outcomes for patients receiving the new drug in a more favorable way than for patients receiving placebo (observer bias) 81 “AFTER” BIAS 1. Selective reporting bias A major and common source of bias in an RCT is selective reporting of results, describing those outcomes with positive results, or which favor the studied intervention. This is not always consciously done. 2. Regulation bias This is sometimes referred to as Bureaucracy bias. It occurs when institutional review boards are overly restrictive, and block the study of important questions. It also occurs when they are overly permissive and allow or even encourage studies that may not be scientifically or socially valid 82 How can we solve it? BLINDING 83 84 85 ¡1A! TRIPLE BLINDING 86 87 QUASI-EXPERIMENTAL RESEARCH Manipulation of the IV , but there is no control group or no random assignment of subjects to different groups. Difficulty in differentiating the specific effects of the IV QUASI-EXPERIMENTAL RESEARCH: • STUDY "BEFORE - AFTER" (PRE-POST) - A single group - A first measurement of the DV (PRE) - Manipulation of the IV (treatment applied) - A second test of DV(POST) ¡Each subject acts as their own control! (example In class with neck manipulation) QUASI-EXPERIMENTAL RESEARCH: Example: • Study to assess the effectiveness of cataract surgery in which the consecutive group of patients was evaluated before and after intervention on relevant variables such as visual acuity, perceived health, ... .. CERVICAL SPINE MANIPULATION Seventy patients with mechanical neck pain (25 males and 45 females, aged 20-55 years) participated in this study. The lateral gliding test was used to establish the presence of an intervertebral joint dysfunction at the C3 through C4 or C4 through C5 levels. Subjects received an Single Cervical High-Velocity LowAmplitude Manipulation The outcome measures were active cervical range of motion and neck pain pretreatment and 5 minutes posttreatment by an assessor blinded to the treatment allocation of the patient. Quasi experimental research MANIPULATION + EXERCISE Altogether, 191 patients with chronic mechanical neck pain were randomized to receive 20 sessions of spinal manipulation combined with rehabilitative neck exercise (spinal manipulation with exercise), MedX rehabilitative neck exercise, or spinal manipulation alone. The main outcome measures were patient-rated neck pain, neck disability, functional health status (as measured by Short Form-36 [SF-36]), global improvement, satisfaction with care and medication use. Range of motion, muscle strength, and muscle endurance were assessed by examiners blinded to patients’ treatment assignment. Experimental research 91 NO EXPERIMENTAL RESEARCH = Descriptive observational Purposes: • Correlation: interrelationship or association between variables • Observe, describe and document various aspects of a situation that occurs naturally 92 TAKE HOME MESSAGES! • RCT – OUR MOST POWERFUL TOOL AS RESEARCHERS. • PROBLEMS WITH RCT´S IN PHYSIOTHERAPY?. • CONCEPTS: - CONTROL GROUP - RANDOMNESS - BLINDING 93 ITEM 4: KNOWLEDGE, RESEARCH ADN SCIENTIFIC DOCUMENTATION THE CONCEPT OF RESEARCH • Scientific Research • Science • Scientific Knowledge • Purposes • Scientific Method STUDY DESIGNS SCIENTIFIC DOCUMENTATION • Classification criteria: • Purpose • Temporal Sequence • Control of the assignment of study factors • Begining of the research in relation with the study facts • DESIGN: •Experimental • quasiexperimental • Non experimental ETICHS IN S.R. SCIENTIFIC ARTICLE • Scientific article: report published in an academic journal that describes a research. • Original article • Reviews, case or case reports, editorials, letters to the editor ....... SCIENTIFIC ARTICLE 1. ORIGINAL ARTICLE Research results are published for the first time - Title - Summary / abstract - Keywords - INTRODUCTION (I) - MATERIALS AND METHODS (M) - RESULTS (R) - DISCUSSION (D) - Conclusions SCIENTIFIC ARTICLE A) TITLE - The first thing you read - Must: - Identify the content - Attractive - Clear, direct and brief - Types: - Descriptive or indicative - Informational SCIENTIFIC ARTICLE A) TITLE - Examples: - Diet and cancer - High prevalence of celiac disease in patients with multiple sclerosis SCIENTIFIC ARTICLE B) ABSTRACT - The first thing you read. It is always showed in bibliographic databases (FREE) - Independent, self-explanatory and intelligible itself. ABSTRACT EXAMPLE 100 SCIENTIFIC ARTICLE B) ABSTRACT Types: - Free - Structured Abstract Free Structured :4 headings Structured: 8 headings - Background / Objectives Objective - Method Design Context / Location Subjects / Participants Interventions Main measurements - Results Results - Conclusions Conclusions SCIENTIFIC ARTICLE C) KEYWORDS - Terms related to the article content - Help to classify the articles and search in bibliographic databases (GOOGLE STYLE). - PAIN, MASSAGE, EXERCISE… 103 104 105 106 SCIENTIFIC ARTICLE D) INTRODUCTION - BACKGROUND Answer the questions: What have we studied? Why is it an important question? What is known about the topic before making this study? How this study will contribute to the improvement of knowledge on the subject? Objective 109 110 SCIENTIFIC ARTICLE E) MATERIAL AND METHODS: - Purpose: To describe the research design and how it was carried out. - You must include enough information for the reader to: - Understand the research process - Reproduce the results MATERIAL AND METHODS EXAMPLE MATERIAL Y MÉTODOS Protocolo de estudio • 25 sujetos Primera valoración 1. Características descriptivas (sexo, edad, profesión, etc.) 2. Datos relacionados con la patología del paciente (duración de los síntomas, lado de los síntomas, horas sentado al día, etc.) 3. Anamnesis (ECO + TESTS) 13 descartados Entrega de Consentimiento Informado • Entrega del FOLLETO CONJUNTO DE ESCALAS DE VALORACIÓ N • PREVIO a cada SESIÓN DE TTO. 1. PS 2. Participación voluntaria en el estudio. MATERIAL AND METHODS EXAMPLE 113 MATERIAL AND METHODS EXAMPLE MATERIAL Y MÉTODOS PROTOCOLO DE ESTUDIO • DURACIÓN: 5 SEMANAS • Tratamiento semanal durante las cuatro primeras semanas (día 1, día 7, día 14 y día 21 exactamente). • ESCALAS + PS + INSTRUCCIÓN MINUCIOSA al paciente en la técnica de ESTIRAMIENTO propuesta MATERIAL AND METHODS EXAMPLE 115 MATERIAL AND METHODS EXAMPLE “VIDEO OF DRY NEEDLING IN QUADRATUS PLANTAE” + “VIDEO OF DRY NEEDLING USING ULTRASOUND IMAGING” 116 MATERIAL AND METHODS EXAMPLE 117 SCIENTIFIC ARTICLE F) RESULTS - Purpose: - Objectively present the research findings which answer to the objectives of the study MÚSCULO TOTAL DE PORCENTAJ INDIVIDUO E DE S PREVALEN CIA Sóleo 11 91,6% Abductor del 10 83,3% 8 66,6% 2 16,6% 12 100% 7 58,3% 5 41,6% 0 0% 0 8,3% 0 0% Primer Dedo Cuadrado Plantar Flexor Corto de los Dedos Gemelo Interno Gemelo Externo Flexor Largo de los Dedos Adductor del Primer Dedo Abductor del Quinto Dedo Extensor Largo de los Dedos 119 SCIENTIFIC ARTICLE G) DISCUSSION - Purpose: to interpret the results in light of what is known about the topic - The results are interpreted: - Compare theories and findings from other studies - The limitations of the study are discussed: self-criticism - Future research 121 SCIENTIFIC ARTICLE H) CONCLUSION Summarizes the main findings taken from the results 123 124 SCIENTIFIC ARTICLE REFERENCES – Sources of information used for writting the article – Every researcher has the right to be cited by subsequent researchers – Most widely used: ICMJE (International Committee of Medical Journal Editors): TAKE HOME MESSAGES! • I know the different parts that make up an article. • And what is included in each one! 126 ARTICLES TYPES •SCIENTIFIC DOCUMENTATION: BIOMEDICAL SCIENCE PUBLICATION • Original Article • Review article • Meta-analysis • Editorial • Clinical Progress Note • Letters to the editor 128 129 130 131 REVIEW ARTICLE: NARRATIVE • Intended to update current knowledge on a given topic • The author selects "under their criteria" studies • They may be biased: subjectivity the reviewer; lack of systematic collection information • Commissioned by the editorial committee of experts in the field 133 REVIEW ARTICLE: SYSTEMATIC • Answer a question delimited • Systematic and specific methodology used to search for articles (original articles) • Scales to assess the methodological quality of the studies • Review of original items of higher quality: OBJECTIVITY 135 Narrative review Systematic review Question General, not concrete Specific clinical question Data Sources and Search Usually not specified. Potentially biased Specific search strategy. Not biased. Selection of studies Usually not specified. Potentially biased Based on uniformly applied criteria. Blinded. Not biased Evaluation of studies Variable Critical and rigorous Data Synthesis Often qualitative Quantitative META-ANALYSIS Statistical assessment with data from the studies reviewed SYSTEMATIC REVIEW + STATISTICS EDITORIAL • Critical reviews of scientific topics • Written by an expert of a specific area CLINICAL PROGRESS NOTE • Communication of clinical observations in order to make a novel contribution to the knowledge of the disease LETTERS TO THE EDITOR • Readers express their comments or questions to the magazine TAKE HOME MESSAGES! • I know the different TYPES OF ARTICLE. • And what is the OBJECTIVE OF EACH ONE! 142 ITEM 4: KNOWLEDGE, RESEARCH ADN SCIENTIFIC DOCUMENTATION THE CONCEPT OF RESEARCH • Scientific Research • Science • Scientific Knowledge • Purposes • Scientific Method STUDY DESIGNS SCIENTIFIC DOCUMENTATION • Classification criteria: • Purpose • Temporal Sequence • Control of the assignment of study factors • Begining of the research in relation with the study facts • DESIGN: •Experimental • quasiexperimental • Non experimental ETICHS IN S.R. Research ethics in Health Sciences ADOPTION OF ETHICAL PRINCIPLES IN RESEARCH: - Research for medical purposes that violate human rights and moral principles: + The nazis (1930 -1940): prisoners of war and "racial enemies“ - Contradictions may exist: + Rights of research subjects and research requirements. Ethical Dilemma: New drug in people with cancer ➢ CODE OF ETHICS: •Nuremberg Code • Declaration of Helsinki 1964 • Fundamental ethical principles: 1. Charity 2. Respect for human dignity 3. Principle of Justice ETHICS COMMITTEE FOR ORIGINAL RESEARCH 1. Charity: a) No damage guaranteed • Physical, mental • Experimentation on animals b) No use of the relationship researcher - subject • No disadvantage for the subject • The data will not be used against them or for other purposes c) Assess the risk / benefit • Information subject 2. Respect for human dignity: Right to self determination - Voluntary decision to participate - Finish participation; refuse to give information. Right to know all the information - Purpose and research design - Right of refusing participation - Risk / benefit information INFORMED CONSENT 3. Principle of justice: Right to receive a fair treatment - Without prejudice to non-volunteers - Compliance of the agreements Right to privacy + Confidentiality: - Anonymity - Privacy promise: no identification of public data; no information available to third parties Research ethics Improper Behaviors Fraudulent data Incomplete Data Manipulated images Conflict of interests Breach of Confidentiality Plagiarism