A brief introduction to Research Methodology

By Dr.Shaikh Shaffi Ahamed Ph.d., Asst. Professor Dept. of Family & Community Medicine

What is Research?What is Research? A systematic investigation, involving the

collection of information (data), to solve aproblem or contribute to knowledge about a theory or practice.

Research is critical in medicine because itleads to new discoveries and can changepeoples’ lives by improving health and well being.

Research helps to provide scientificunderstanding and solves practical problems.

Research (cont.)Research (cont.)

Relies on methods and principles that willproduce credible and verifiable results.

All research starts with an idea or

question based on personal experiences.

Scientific ApproachScientific ApproachThe most sophisticated method of acquiringknowledge is by scientific approach.

Combines important features of inductionand deduction together with other methodsto create a system of acquiring knowledge.

Generally more reliable than other methods.

Approach used most often to performmedical research.

Scientific researchis an integrated approach of deduction and induction

DeductionHypothesis generation

Testing the hypothesis

Induction(Inference on hypothesis)generalization of the results

In sample population

Universe

Known/unknown truths

Aims of epidemiologic research

• Describe the health status of a population

• Explain the etiology of disease

• Predict the disease occurrence

• Control the disease distribution

Definition of Epidemiology

• The study of the distribution and determinants of health-related states or events in specified population, and the application of this study to control of health problems.

[source: Last (ed.) Dictionary of Epidemiology, 1995]

Definition of Epidemiology• Study: surveillance, observation, hypothesis

testing, analytic research, and experiments.

• Distribution: analysis by time, place, and person.

• Determinants: physical, biological, social, cultural, and behavioral factors that influence health.

• Health-related states or events: diseases, causes of death, behavior, reactions to preventive regimens, and provision and use of health services.

Epidemiology and Biostatistics

Epidemiology:Study design andinterpretation

Biostatistics:Methods for analysis

Policy making, planning,Management evaluation

Health systems research

Epidemiological

Biomedical

Statistical

Behavioral

Social & economic

MODEL OF THE RELATIONSHIP BETWEEN DIFFERENT TYPES OF RESEARCH

BCG vaccination is not effective. Why ?(a) BCG vaccination coverage is good but not effective(i) Immuno-microbiological factors Poor nutrition (low protein intake) Poor immune reaction (race-specific) Tubercle bacillus strains Atypical mycobacterial infection ---- BIOMEDICAL PROBLEMS(ii) Technical factors Quality of BCG vaccine ---- BIOMEDICAL PROBLEMS(iii) Operational factors Storage and transport of vaccine Handling of vaccine after reconstitution Technique of vaccination Logistic support (supply of vaccine, vaccinating equipment) ----- HEALTH SYSTEMS RESEARCH

(b) BCG vaccination coverage is poor

(i) Operational factors

Coverage and efficiency of local

health services

---- HEALTH SYSTEMS RESEARCH

(ii) Human factors

Indifference of population toward

immunization

Fear of reaction and low level of

confidence in BCG

Decline in concern about tuberculosis

----- BEHAVIOURAL PROBLEMS

Preventable Causes of Disease

BEINGS

• Biological factors and Behavioral Factors

• Environmental factors

• Immunologic factors

• Nutritional factors

• Genetic factors

• Services, Social factors, and Spiritual factors

[JF Jekel, Epidemiology, Biostatistics, and Preventive Medicine, 1996]

Causal model of risk factors for CVDCausal model of risk factors for CVD

Morbidity and Mortality(Stroke, MI)

Biological Risk Factors

(Hypertension, Blood Lipids, Homocysteine)

Genetic Risk Factors(Family History)

Behavioral Risk Factors(Cigarette, Diet, Exercise)

Environmental Factors(Socioeconomic Status, Work Environment)

Clinical issues and questions in Clinical issues and questions in the practice of medicinethe practice of medicine

Issue QuestionNormality/abnormality Is a person sick or well? What abnormalities are associated

with having a disease ?

Diagnosis

How accurate are diagnostic tests or strategies used to find a disease ?

Frequency How often does a disease occur ?

Risk What factors are associated with an increased likelihood of disease ?

Prognosis What are the consequences of having a disease ?

Treatment How does treatment change the future course of a disease ?

Prevention Does intervention on people without disease keep disease from arising?

Does early detection and treatment improve the course of disease ?

Cause What conditions result in disease ? What are the pathogen tic mechanisms of disease ?

Execution of Research:Conceptualizing the problem: Need Background & RationaleFormulating the Objectives Generating hypotheses Testing hypothesesDesigning the Approach Research design Methods and Materials Target population Study population Methods of collectionAnalysis and Interpretation of results

THERE ARE ONLY A THERE ARE ONLY A HANDFUL OF WAYS TO HANDFUL OF WAYS TO DO A STUDY PROPELY DO A STUDY PROPELY BUT A THOUSAND WAYS BUT A THOUSAND WAYS TO DO IT WRONG --- TO DO IT WRONG --- Sackett (1986)Sackett (1986)