Sealing wax and bits of stringSealing wax and bits of string- good outputs from limited inputs- good outputs from limited inputs

Professor Colin P. BradleyProfessor Colin P. BradleyProfessor of General Practice Professor of General Practice

University College CorkUniversity College Cork

Half full or half empty?Half full or half empty?

– We have very few We have very few resources so we resources so we can do very littlecan do very little

– We can be We can be ingenious with our ingenious with our meagre resources meagre resources and do quite a lotand do quite a lot

Two ways of looking at research in Irish general practice/ primary care

Some examples of ingenious use of Some examples of ingenious use of limited resourceslimited resources

Epidemiology in Country Practice – Pickles, Epidemiology in Country Practice – Pickles, 19391939

The Medical Life History of Families – The Medical Life History of Families – Huygen, 1978Huygen, 1978

Clinical judgement and antibiotic prescribing Clinical judgement and antibiotic prescribing – Howie, 1976– Howie, 1976

The consultation and the therapeutic illusion The consultation and the therapeutic illusion – Thomas, 1978– Thomas, 1978

The B-score – Dobbs 1996The B-score – Dobbs 1996

Small studies can have a bit impactSmall studies can have a bit impact

Goffman’s ‘Assylums’Goffman’s ‘Assylums’

McBride – letter to Lancet highlighting McBride – letter to Lancet highlighting thalidomide disasterthalidomide disaster

Significant event analysis studySignificant event analysis study

Uncomfortable prescribing studyUncomfortable prescribing study

Strategies for managing limited Strategies for managing limited resourcesresources

Keep the study smallKeep the study small– Limiting ambitionLimiting ambition

Pilot and exploratory studiesPilot and exploratory studies Hypothesis generation studies - qualitativeHypothesis generation studies - qualitative Transfer of setting studies – concept proven Transfer of setting studies – concept proven

elsewhere, does it work here?elsewhere, does it work here? Using non-research resources for research Using non-research resources for research

purposespurposes Collaboration – other practices, settings, Collaboration – other practices, settings,

researchers – international collaborationsresearchers – international collaborations Secondary research e.g. systematic reviewsSecondary research e.g. systematic reviews

Some take home messagesSome take home messages You must cut your coat to suit your clothYou must cut your coat to suit your cloth

– Studies have to be scaled to answer the questions Studies have to be scaled to answer the questions they pose (power calculations) they pose (power calculations)

Try to develop questions of a size you can Try to develop questions of a size you can answeranswer

Be originalBe original Be rigorous/ thoroughBe rigorous/ thorough Do the best research you can with whatever Do the best research you can with whatever

resources you haveresources you have Qualitative research is a good option but not a Qualitative research is a good option but not a

complete solutioncomplete solution