For Archmage ONLY

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AHCP 5330

Introduction to Informatics

Research Methods and Evidence-Based Medicine

Research Methods

Quantitative Qualitative

Quantitative Most common, most familiar Numbers, Statistics Sensitivity, Specificity TP, TN, FP, FN Accuracy, Precision Positive Predictive Value Negative Predictive Value Null hypothesis Bayes’ theorem

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Examples of good, quantitative research studies can be found in almost any peer reviewed journal

Qualitative Less common, less familiar Some research doesn’t lend itself to

numerical and statistical analysis Observations, interviews, biographies,

historical accounts No numbers (OK, maybe a few) ? “fuzzy” research – NOT Good qualitative research is

reproducible

Some examples of good qualitative research studies:

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The Stanford Prison Experiment

Philip Zimbardo

The Perils of Obedience

Stanley Milgram

A Consensus Statement on Considerations for a Successful

CPOE Implementation

Joan S. Ash, PhD, MLS, P. Zoë Stavri, PhD, MLS, and Gilad J. Kuperman, MD, PhD

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Evidence-Based Medicine

Definition:

Evidence-based medicine is the use of information derived from

research for making well-informed clinical decisions

Principles of evidence-based medicine:

1. Evidence alone is never sufficient to make a clinical decision

2. There is a hierarchy of evidence

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Hierarchy of evidence:

a) N-of-1 randomized controlled trial b) Systematic review of randomized trials c) Single randomized trial d) Systematic review of observational

studies addressing patient-important outcomes e) Single observational study addressing

patient-important outcomes f) Physiologic study g) Unsystematic clinical observation

Critical thinking –

Are the results valid? How large was the therapeutic effect? Are the results statistically meaningful? Are they worthwhile? Can I use the information?

References Resources for finding EBM studies:

Chochrane Collaboration http://www.cochrane.org

PubMed, http://www.pubmed.gov

emedicine, http://www.emedicine.com

Medscape, http://www.medscape.com

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References: Resources for finding EBM studies:

Chochrane Collaboration http://www.cochrane.org

PubMed

http://www.pubmed.gov emedicine

http://www.emedicine.com Medscape

http://www.medscape.com

Reference – The Stanford Prison Experiment

http://www.prisonexp.org/links.htm

Click on “Selected Articles by Dr. Zimbardo”, then click on “Interpersonal Dynamics in a Simulated Prison (IJCP, 1973)”

References – “Perils of Obedience”

• Description of the experiment:

– http://www.nmmi.edu/academics/leadership/documents/Milgram- Obedience2.pdf

• Clips of a three part series showing a recreation of the experiment:

– http://www.youtube.com/watch?v=BcvSNg0HZwk

– http://www.youtube.com/watch?v=IzTuz0mNlwU&NR=1

– http://www.youtube.com/watch?v=CmFCoo-cU3Y&feature=related

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Reference – CPOE

A Consensus Statement on Considerations for a Successful CPOE Implementation

Joan S. Ash, PhD, MLS, P. Zoë Stavri, PhD, MLS, and Gilad J. Kuperman, MD, PhD

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC342045/ ?tool=pubmed

Practical Research: Planning and Design Leedy, Paul and Jeanne Ellis Ormrod

Qualitative Research Methods for the Social Sciences Berg, Bruce

Doing Qualitative Research Crabtree, Miller

References – Research Methods

References – Evidence based medicine:

“Users’ Guides to the Medical Literature – A Manual for Evidence-based Clinical Practice”, 2nd ed.

“Users’ Guides to the Medical Literature – Essentials of Evidence- based Clinical Practice”, 2nd ed. (this is a shorter, pocket-book

version, of the above book)

both books are by Gordon Guyatt, Drummond Rennie, Maureen Meade, Deborah Cook, eds, The McGraw-Hill Companies, Inc.,

2008

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AHCP 5330

End of the lesson

Research Methods and Evidence-Based Medicine