Research MethodsResearch Methods

Anatomy of a Research ArticleAnatomy of a Research Article

Anatomy of a Research PaperAnatomy of a Research Paper

Dissecting the Basis Product of Research the Dissecting the Basis Product of Research the Published Research ArticlePublished Research Article

Research Journals**Research Journals**

Editorials, commentaries, letters to the Editorials, commentaries, letters to the editor…..(points of view or opinion)editor…..(points of view or opinion)

Literature reviews…..(summarizes other work)Literature reviews…..(summarizes other work) Descriptive studies…..(observe/record and Descriptive studies…..(observe/record and

explain findings)explain findings) Experiments…..(researcher actively designs Experiments…..(researcher actively designs

and places controls on the study) and places controls on the study)

Critical ReadingCritical Reading

Knowing the elements of a article and what Knowing the elements of a article and what each element is supposed to accomplish gives each element is supposed to accomplish gives us the knowledge upon which to evaluate the us the knowledge upon which to evaluate the quality of researchquality of research

Elements of a Research Article Elements of a Research Article (IMRaD format)**(IMRaD format)**

AbstractAbstract IntroductionIntroduction MethodsMethods ResultsResults DiscussionDiscussion ConclusionsConclusions ReferencesReferences

Abstract**Abstract**

Summary of article (Usually 250 words or Summary of article (Usually 250 words or less)less) DesignDesign ObjectivesObjectives BackgroundBackground MethodsMethods ResultsResults ConclusionsConclusions

Abstract**Abstract**

Dangerous to read only abstract due to limited Dangerous to read only abstract due to limited information and possible author biasinformation and possible author bias

If the abstract is not structured, be very If the abstract is not structured, be very cautiouscautious

If abstract does not address randomization, If abstract does not address randomization, bewarebeware

If results only expressed as “p” value, caution If results only expressed as “p” value, caution advisedadvised

Introduction**Introduction**

Discusses the importance and purpose of the Discusses the importance and purpose of the researchresearch

Reviews previous related researchReviews previous related research States hypothesis being testedStates hypothesis being tested

Methods*** Methods***

Most important portion of an articleMost important portion of an article Includes:Includes:

DesignDesign Subject or population usedSubject or population used Subject selectionSubject selection ProceduresProcedures Variables measuredVariables measured Statistical analysis (Descriptive and analytic)Statistical analysis (Descriptive and analytic)

Research Variables**Research Variables**

How measuredHow measured Quality of measures (reliability, accuracy, Quality of measures (reliability, accuracy,

validity)validity) Incomplete information makes measuring the Incomplete information makes measuring the

adequacy of the research difficultadequacy of the research difficult

Results**Results**

Summarizes all pertinent dataSummarizes all pertinent data Tables and graphsTables and graphs Results of statistical analysisResults of statistical analysis Reports all research outcomes related to the Reports all research outcomes related to the

stated hypothesisstated hypothesis

Discussion**Discussion**

Interprets data and discusses the importance of Interprets data and discusses the importance of the researchthe research

Identifies weaknessIdentifies weakness Outlines need for future researchOutlines need for future research

Cautions**Cautions**

Especially subject to author biasEspecially subject to author bias Look for exaggerations or inappropriate Look for exaggerations or inappropriate

conclusionsconclusions Look for errors in statisticsLook for errors in statistics

References*References*

Author consideration of other workAuthor consideration of other work Quality of other work (JMPT, Gray’s Quality of other work (JMPT, Gray’s

Anatomy, National Inquirer, etc.)Anatomy, National Inquirer, etc.) How recent the references?How recent the references? Other important research omitted?Other important research omitted? Do most supporting references come from the Do most supporting references come from the

author?author?

Acknowledgements*Acknowledgements*

Usually in bottom left hand cornerUsually in bottom left hand corner Describes funding and assistanceDescribes funding and assistance Author contact and information about reprintsAuthor contact and information about reprints

Abstract and Conclusion**Abstract and Conclusion**

““doubtful or invalid statements were found in doubtful or invalid statements were found in 76% of the conclusions or abstracts”76% of the conclusions or abstracts”

Controlled Clinical Trials, Controlled Clinical Trials, 1989, 10:31-561989, 10:31-56

SummarySummary

Abstract- Summary of the researchAbstract- Summary of the research Introduction- Importance, literature review, Introduction- Importance, literature review,

hypothesishypothesis Methods- Design, sample selection, data Methods- Design, sample selection, data

collectioncollection Results- Data summarized, analysis of data, Results- Data summarized, analysis of data,

tables and chartstables and charts Discussion- Conclusions supported, no Discussion- Conclusions supported, no

exaggerations, weakness statedexaggerations, weakness stated

References- Adequate, timely, quality References- Adequate, timely, quality

Neuro Emotional Technique for the treatment of Neuro Emotional Technique for the treatment of trigger point sensitivity in chronic neck pain trigger point sensitivity in chronic neck pain

sufferers: A controlled clinical trialsufferers: A controlled clinical trialPeter BablisPeter Bablis1, 1, Henry PollardHenry Pollard1,2 and 1,2 and Rod Rod

BonelloBonello1 1

At all four trigger points, the average change At all four trigger points, the average change in both VAS scores and PGA measurements in both VAS scores and PGA measurements for the treatment group was strongly for the treatment group was strongly significantly different (P < 0.001) from that for significantly different (P < 0.001) from that for the control group. The mean changes for the the control group. The mean changes for the two groups are presented in Table two groups are presented in Table 33. .

This study investigated the effects of Neuro This study investigated the effects of Neuro Emotional Technique (NET) on the sensitivity Emotional Technique (NET) on the sensitivity of trigger points presenting in regions of the of trigger points presenting in regions of the neck including the suboccipital region, levator neck including the suboccipital region, levator scapulae region, sternocleidomastoid insertion scapulae region, sternocleidomastoid insertion region and temporomandibular region, in a region and temporomandibular region, in a cohort of chronic neck pain sufferers. The cohort of chronic neck pain sufferers. The results of the study could provide useful results of the study could provide useful information or the treatment of cervical pain information or the treatment of cervical pain and related psychosocial problems.and related psychosocial problems.

The successful clinic based outcomes suggest The successful clinic based outcomes suggest that a mind body approach to the management that a mind body approach to the management of trigger points with NET should be of trigger points with NET should be considered in the management of trigger points considered in the management of trigger points in neck pain sufferers. Further evidence is in neck pain sufferers. Further evidence is required for better substantiation of the use in required for better substantiation of the use in conservative management, with randomised conservative management, with randomised controlled trials for the effect of NET on controlled trials for the effect of NET on chronic neck pain, and other chronic pain chronic neck pain, and other chronic pain syndromes recommended. syndromes recommended.

This research was performed in a private This research was performed in a private practice setting in Sydney, Australia. A practice setting in Sydney, Australia. A convenience sample of sixty consecutive convenience sample of sixty consecutive participants was recruited from new patients participants was recruited from new patients presenting during the period between February presenting during the period between February 2005 and June 2005. Every third consecutive 2005 and June 2005. Every third consecutive chronic neck pain participant was allocated to chronic neck pain participant was allocated to a blinded control group to eliminate selection a blinded control group to eliminate selection bias. bias.

No funding was received in the preparation of this No funding was received in the preparation of this manuscript.manuscript.

PB: Is a research student of Macquarie University.PB: Is a research student of Macquarie University. HP: is a part time employee of 'The ONE (Our Net HP: is a part time employee of 'The ONE (Our Net

Effect) Research Foundation', a non-profit Effect) Research Foundation', a non-profit organisation. As an employee of this organization his organisation. As an employee of this organization his interest in this research would relate to the interest in this research would relate to the foundation's mission statement: to establish natural foundation's mission statement: to establish natural healing as a standardised care through Neuro-healing as a standardised care through Neuro-Emotional Technique (NET) research, education and Emotional Technique (NET) research, education and public service.public service.

RB: No competing interests.RB: No competing interests.

Human Subject Protection*Human Subject Protection*

Historically fraught with abusing human Historically fraught with abusing human beingsbeings

Historically norms for human subjects were Historically norms for human subjects were left in the hands of investigatorsleft in the hands of investigators

Some abuses were unintentional and others Some abuses were unintentional and others were part of the research design.were part of the research design.

““Nurenburg Code”*Nurenburg Code”*

In response to NAZI atrocities after WW IIIn response to NAZI atrocities after WW II Key concept was voluntary participationKey concept was voluntary participation Considered by many unnecessary in the United Considered by many unnecessary in the United

States.States.

Belmont ReportBelmont Report

19791979 A statement of basic ethical principles and A statement of basic ethical principles and

guidelines addressing ethical problems guidelines addressing ethical problems associated with human subject research. associated with human subject research.

Forms the basis for conduct of all US human Forms the basis for conduct of all US human research research

Thalidomide*Thalidomide*

19621962 Dramatically changed the publics attitude Dramatically changed the publics attitude

toward biomedical researchtoward biomedical research Congress passed laws requiringCongress passed laws requiring

“ “informed consent”informed consent” Safety as well as efficacy must be proved.Safety as well as efficacy must be proved.

Brooklyn Jewish Chronic Disease Brooklyn Jewish Chronic Disease Hospital*Hospital*

NIH funded studyNIH funded study 19641964 Cancerous cells injected into debilitated Cancerous cells injected into debilitated

patientspatients those that gave informed consent were not told the those that gave informed consent were not told the

cells were cancerous.cells were cancerous.

Willowbrook State Hospital for Willowbrook State Hospital for the Retarded*the Retarded*

1960’s1960’s Injection of mild hepatitis strain into children Injection of mild hepatitis strain into children

on admission to school.on admission to school.

Tuskegee Syphilis Study*Tuskegee Syphilis Study*

Began in 1932Began in 1932 Designed to trace natural history of syphilisDesigned to trace natural history of syphilis Participants (poor black males) were misled to Participants (poor black males) were misled to

believing they were being treated for syphilisbelieving they were being treated for syphilis Exposed in 1972 by the New York TimesExposed in 1972 by the New York Times National Commission for the Protection of National Commission for the Protection of

Human Subjects of Biomedical and Behavior Human Subjects of Biomedical and Behavior Research.Research.

Face Lift Study*Face Lift Study*

19951995 Plastic surgeons at a New York City Hospital Plastic surgeons at a New York City Hospital

compared two facelift procedurescompared two facelift procedures To test procedures one half of the face tested To test procedures one half of the face tested

one method the other side the other methodone method the other side the other method Consent forms indicated only routine surgery.Consent forms indicated only routine surgery.

Mosquito Study*Mosquito Study*

Annuals of Internal MedicineAnnuals of Internal Medicine Subjects were exposed to large mosquito Subjects were exposed to large mosquito

population…population… Protected subjects received 1 bite over an 8 Protected subjects received 1 bite over an 8

hour periodhour period Unprotected subjects had 1,188 bites per hour, Unprotected subjects had 1,188 bites per hour,

9,504 for 8 hours.9,504 for 8 hours.

Institutional Review Board***Institutional Review Board***

Only entity within research with the primary Only entity within research with the primary purpose of protecting the participantpurpose of protecting the participant

ResponsibilitiesResponsibilities Reviewing research prior to study to ensure Reviewing research prior to study to ensure

participants are protected participants are protected Monitor progress of research to ensure protection Monitor progress of research to ensure protection

of participantsof participants Ensure research is following its own protocols. Ensure research is following its own protocols.

Informed Consent**Informed Consent**

Designed to protect human subjectsDesigned to protect human subjects Participants must know risks and benefits of Participants must know risks and benefits of

study.study.

Research not covered by the Research not covered by the Federal system*Federal system*

Some Some in vitro in vitro fertilization clinicsfertilization clinics Some weight loss or diet clinicsSome weight loss or diet clinics Some physicians officesSome physicians offices Some colleges and universitiesSome colleges and universities Research in development of genetic tests. Research in development of genetic tests.

Classifications of Research Classifications of Research DesignDesign

Pre-experimentalPre-experimental Quasi-experimentalQuasi-experimental ExperimentalExperimental

Pre-experimental (Descriptive)***Pre-experimental (Descriptive)***

Purpose is to observe and describePurpose is to observe and describe Does not offer explanations, provide causes or Does not offer explanations, provide causes or

provide evidenceprovide evidence May lead to additional researchMay lead to additional research

Types of pre-experimental design**Types of pre-experimental design**

SurveysSurveys Case reportsCase reports Case seriesCase series Historical researchHistorical research

Case Reports**Case Reports**

Not experimental and can not prove anything, Not experimental and can not prove anything, but still very importantbut still very important

AIDS, Lyme disease first described as a case AIDS, Lyme disease first described as a case reportsreports

X----------------O X is the independent X----------------O X is the independent variable (treatment) and O is the observation variable (treatment) and O is the observation of the dependent variable (blood pressure, of the dependent variable (blood pressure, weight, pain)weight, pain)

Case Series***Case Series***

Also known as “one group pretest-posttest Also known as “one group pretest-posttest design”design”

Same as case report but uses a groupSame as case report but uses a group O--------------X-------------OO--------------X-------------O

Pre-experimental design***Pre-experimental design***

StrengthsStrengths InexpensiveInexpensive Relatively easy to Relatively easy to

performperform

WeaknessesWeaknesses Minimal controlsMinimal controls Cannot show Cannot show

contributory causecontributory cause

Quasi-Experimental Designs***Quasi-Experimental Designs***

Characterized by Characterized by moderate controlsmoderate controls

Non-equivalent control Non-equivalent control group designgroup design

O----------X-----------O O----------X-----------O O-----------------------O O-----------------------O

Quasi-experimental design***Quasi-experimental design***

StrengthsStrengths Relatively easy to Relatively easy to

performperform Less expensive than Less expensive than

experimental designexperimental design

WeaknessWeakness Moderate controlsModerate controls Cannot show Cannot show

contributory causecontributory cause

True experimental design***True experimental design***

Use of strong controlsUse of strong controls Random assignment to Random assignment to

groupsgroups Manipulation of the Manipulation of the

independent variableindependent variable

R-----O-----X-----O R-----O-----X-----O R-----O------------OR-----O------------O

Experimental design***Experimental design***

StrengthsStrengths Strong controlsStrong controls Can show contributory Can show contributory

causecause

WeaknessesWeaknesses ExpensiveExpensive Difficult to performDifficult to perform Ethical issues relating to Ethical issues relating to

control groupcontrol group Participant recruitment Participant recruitment

often a problemoften a problem

Other Forms of Research*Other Forms of Research*

Meta Analysis (Putting together the data from Meta Analysis (Putting together the data from various RCT’s)various RCT’s)

Qualitative studies (Objective study of the Qualitative studies (Objective study of the human experience using nonstatistical human experience using nonstatistical analysis)analysis)

Other common design terms***Other common design terms***

Cross-sectional studyCross-sectional study Measurement of presumed cause and effect at the Measurement of presumed cause and effect at the

same timesame time Capable of measuring prevalence (proportion of Capable of measuring prevalence (proportion of

pop. with outcome at one point in time)pop. with outcome at one point in time) Doctor visit common prior to ones death. Is the doctor Doctor visit common prior to ones death. Is the doctor

visit a risk factor?visit a risk factor?

Cross-over design: treatment group and Cross-over design: treatment group and control group switch rolescontrol group switch roles

Other common design terms***Other common design terms***

Longitudinal Study: carried out over timeLongitudinal Study: carried out over time Retrospective: Grouping by presence or absence of Retrospective: Grouping by presence or absence of

outcome and review of past historyoutcome and review of past history Hypertension study grouped by outcome, presence or Hypertension study grouped by outcome, presence or

absence of hypertensionabsence of hypertension Prospective : Observations made over a period of Prospective : Observations made over a period of

time as the events occurtime as the events occur A RCT is a longitudinal prospective studyA RCT is a longitudinal prospective study

Terminology***Terminology***

Bias: Distortion introduced into research data Bias: Distortion introduced into research data by experimenter, instrumentation, participants by experimenter, instrumentation, participants or proceduresor procedures

Blinding: Experimenter in contact with Blinding: Experimenter in contact with subjects ignorant of participants category subjects ignorant of participants category and/or participant is ignorant of category and/or participant is ignorant of category

Cohort: Group of individuals moving through Cohort: Group of individuals moving through some process as a group.some process as a group.

Terminology***Terminology***

Control group: comparison group to Control group: comparison group to experimental groupexperimental group

Dependent variable: data measures in research Dependent variable: data measures in research studystudy

Independent variable: phenomenon of interest Independent variable: phenomenon of interest in a research study (treatment)in a research study (treatment)

Intra-rater reliability: Consistency of Intra-rater reliability: Consistency of observations of the same observer at different observations of the same observer at different timestimes

Terminology***Terminology***

Inter-rater reliability: Consistency of Inter-rater reliability: Consistency of observations of between observers in a observations of between observers in a research studyresearch study

Likert scale: Format for questionnaires in Likert scale: Format for questionnaires in which subjects indicate degree of agreement or which subjects indicate degree of agreement or disagreement.disagreement.

Manipulation: Changes in the level of the Manipulation: Changes in the level of the independent variable.independent variable.

Terminology***Terminology***

Practice effects: The effect taking a test more Practice effects: The effect taking a test more than one time has on the outcome of than one time has on the outcome of subsequent tests.subsequent tests.

Randomization: Choosing groups in such a Randomization: Choosing groups in such a manner that the participant has an equal manner that the participant has an equal chance of being in either groupchance of being in either group

Reliability: Stability or repeatability Reliability: Stability or repeatability

Terminology***Terminology***

Test-retest reliability: The stability of a test Test-retest reliability: The stability of a test determined by administering the test, waiting determined by administering the test, waiting an interval and readministering the test and an interval and readministering the test and correlating test results.correlating test results.

Validity: Relates to a test measuring what it Validity: Relates to a test measuring what it has been designed to measure.has been designed to measure.

……