Research Methodology

Working with Toronto neighbourhoods toward developing indicators of community capacity.

Anonymous — Tue, 24 Aug 2021 15:42:03 +0000

Working with Toronto neighbourhoods toward developing indicators of community capacity. Anonymous (not verified) Tue, 08/24/2021 - 11:42

Often the goal of health and social development agencies is to assess communities and work with them to improve community capacity. Particularly for health promoters working in community settings and to ensure consistency in the definition of health promotion, the evaluation of health promotion programmes should be based on strengths and assets, yet existing information for planning and evaluation purposes usually focuses on problems and deficits. A model and definition of community capacity, grounded in community experience and focusing on strengths and assets, was developed following a 4-year, multi-site, qualitative, action research project in four Toronto neighbourhoods. There was significant community involvement in the four Community Advisory Committees, one for each study site. Semi-structured, open-ended interviews and focus groups were conducted with 161 residents and agency workers identified by the Community Advisory Committees. The data were analyzed with the assistance of NUDIST software. Thematic analysis was undertaken in two stages: (i) within each site and (ii) across sites, with the latter serving as the basis for the development of indicators of community capacity. This paper presents a summary of the research, the model and the proposed indicators. The model locates talents and skills of community members in a larger context of socioenvironmental conditions, both inside and outside the community, which can act to enable or constrain the expression of these talents and skills. The significance of the indicators of community capacity proposed in the study is that they focus on identifying and measuring the facilitating and constraining socioenvironmental conditions. PMID: 14695365

Author

Jackson SF, Cleverly S, Poland B, Burman D, Edwards R, Robertso

Citedate

2003-01-01

Citation

Health Promot. Internation., 2003;18(4):339-350.

Affiliations

University of Toronto

Publication

http://heapro.oxfordjournals.org/content/18/4/339.full

Taxonomy

Research Methodology

The quality of randomized trial reporting in leading medical journals since the revised CONSORT statement.

Anonymous — Tue, 24 Aug 2021 15:42:02 +0000

The quality of randomized trial reporting in leading medical journals since the revised CONSORT statement. Anonymous (not verified) Tue, 08/24/2021 - 11:42

If randomized controlled trials (RCTs) are to fulfill their potential to allow health care providers to make informed inferences about the validity of the trials upon which they base their clinical practice, then the reporting of key methodological factors must improve. The revised Consolidated Standards for Reporting Trials (CONSORT) were developed to improve the suboptimal reporting of RCTs. We aimed to determine the extent to which RCTs report key methodological factors included in the revised CONSORT recommendations following publication of these recommendations. We conducted an observational study of RCTs published between July 2002 and June 2003 in 5 leading general medicine journals. We determined the proportion and 95% confidence intervals of RCTs that reported sequence generation, allocation concealment, randomization implementation, blinding status of participants, health care providers, outcome assessors, and data analysts, sample size justification, method of analysis (e.g. intention-to-treat), and a participant flow diagram. We included a total of 253 RCTs. RCTs reported: sequence generation 80% (95% CI 75-80%), allocation concealment 48% (95% CI 42-54%), randomization implementation 55% (95% CI 49-61%), blinding status of participants 40% (34-46%), health care providers 17% (95% CI 13-22%), outcome assessors 47% (95% CI 41-53%), data analysts 15% (10-19%), sample size justification 83% (95% CI 78-87%), method of analysis 87% (95% CI 83-91%)), and participant flow diagrams 86% (95% CI 82-90%). Although reporting of some CONSORT recommendations is high, reporting of several essential recommendations remains suboptimal. Authors need to comply with and journals need to enforce reporting of the revised CONSORT recommendations. PMID: 16054580

Author

Mills EJ, Montori VM, Ross CP, Shea B, Wilson K, Guyatt GH.

Citedate

2005-01-01

Citation

J Clin Epidemiol, 2005;58(11):1101-8.

Affiliations

McMaster University, Mayo Clinic, College of Medicine, Mount Sinai Hospital, Institute of Population Health, Toronto General Hospital

Taxonomy

Research Methodology

Systematically reviewing qualitative studies complements survey design: exploratory study of barriers to paediatric immunization

Anonymous — Tue, 24 Aug 2021 15:42:02 +0000

Systematically reviewing qualitative studies complements survey design: exploratory study of barriers to paediatric immunization Anonymous (not verified) Tue, 08/24/2021 - 11:42

BACKGROUND AND OBJECTIVES: Designing survey questions requires content expertise, awareness of previous qualitative literature, and piloting. We examined surveys addressing parental barriers to vaccinating children to determine if they comprehensively included themes identified in published qualitative studies. METHODS: We performed a systematic literature search of 12 electronic databases and compared questions asked in eligible surveys identified to issues raised in qualitative studies. Issues included nine themes related to harm, six related to distrust, eight to issues of access, and three other issues. RESULTS: The 29 eligible surveys failed to adequately address several important themes identified in qualitative studies. The number that failed to address the following themes were as follows: beliefs that vaccines cause diseases (n = 26); painful (n = 25); distrust of medical community (n = 28); communication problems with staff (n = 25); memories of their own or others adverse experiences (n = 28); fear of long-term effects (n = 26); belief the medical community does not understand adverse events associated with vaccines (n = 28); and parent's own lack of knowledge about diseases (n = 29). CONCLUSIONS: Many surveys of parental barriers to immunization failed to address a number of important themes identified in qualitative studies. To the extent this is true in other areas, ensuring that investigators have conducted an adequate number and variety of qualitative studies, and systematically reviewing those studies, will improve surveys' content validity. PMID: 16223652

Author

Mills EJ, Montori VM, Ross CP, Shea B, Wilson K, Guyatt GH.

Citedate

2005-01-01

Citation

J Clin Epidemiol, 2005;58(11):1101-8.

Affiliations

McMaster University, Mayo Clinic, College of Medicine, Mount Sinai Hospital, Institute of Population Health, Toronto General Hospital

Taxonomy

Research Methodology

Problems with use of composite end points in cardiovascular trials: a systematic review.

Anonymous — Tue, 24 Aug 2021 15:41:59 +0000

Problems with use of composite end points in cardiovascular trials: a systematic review. Anonymous (not verified) Tue, 08/24/2021 - 11:41

OBJECTIVE: To explore the extent to which components of composite end points in randomized controlled trials vary in importance to patients, the frequency of events in the more and less important components, and the extent of variability in the relative risk reductions across components.DESIGN: Systematic review of randomized controlled trials. DATA SOURCES: Cardiovascular randomized controlled trials published in the Lancet, Annals of Internal Medicine, Circulation, European Heart Journal, JAMA, and New England Journal of Medicine, from 1 January 2002 to 30 June 2003. Component end points of composite end points were categorized according to importance to patients as fatal, critical, major, moderate, or minor.RESULTS: Of 114 identified randomized controlled trials that included a composite end point of importance to patients, 68% (n=77) reported complete component data for the primary composite end point; almost all (98%; n=112) primary composite end points included a fatal end point. Of 84 composite end points for which component data were available, 54% (n=45) showed large or moderate gradients in both importance to patients and magnitude of effect across components. When analyzed by categories of importance to patients, the most important components were associated with lower event rates in the control group (medians of 3.3-3.7% for fatal, critical, and major outcomes; 12.3% for moderate outcomes; and 8.0% for minor outcomes). Components of greater importance to patients were associated with smaller treatment effects than less important ones (relative risk reduction of 8% for death and 33% for components of minor importance to patients). CONCLUSION: The use of composite end points in cardiovascular trials is frequently complicated by large gradients in importance to patients and in magnitude of the effect of treatment across component end points. Higher event rates and larger treatment effects associated with less important components may result in misleading impressions of the impact of treatment. PMID: 17403713

Author

Ferreira-GonzÃ¡lez I, Busse JW, Heels-Ansdell D, Montori VM, Akl EA, Bryant DM, Alonso-Coello P, Alonso J, Worster A, Upadhye S, Jaeschke R, SchÃ¼nemann HJ, Permanyer-Miralda G, Pacheco-Huergo V, Domingo-Salvany A, Wu P, Mills EJ, Guyatt GH.

Citedate

2007-01-01

Citation

BMJ, 2007;334(7597):786.

Affiliations

Universitat Autònoma de Barcelona, Hospital Vall d'Hebron, Hospital General Vall d'Hebron, McMaster University, Mayo Clinic College of Medicine, University at Buffalo, Italian National Cancer Institute Regina Elena, University of Western Ontario, Hospital

Publication

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1852019/

Taxonomy

Research Methodology

Epidemiology and reporting of randomized trials employing re-randomization of patient groups

Anonymous — Tue, 24 Aug 2021 15:41:59 +0000

Epidemiology and reporting of randomized trials employing re-randomization of patient groups Anonymous (not verified) Tue, 08/24/2021 - 11:41

Trials employing re-randomization of some or all participants provide opportunities for determining optimal dosing and dosing schedules, potential disease modifying effects, direct comparisons between drugs, and salvage therapy for patients failing their assigned treatments. To date, no data exists about their prevalence, epidemiology, or quality. We undertook a systematic review of all trials re-randomizing patients. Using explicit search criteria, we searched 11 electronic databases independently, in duplicate. We additionally searched pharmaceutical company websites for unpublished studies. We extracted data on the epidemiology of trials, year published, characteristics of the purpose of the re-randomization, what groups of patients were re-randomized, and methodological issues, including allocation, concealment, sequence generation, blinding, intention to treat, and appropriate sample size calculations. We found 65 trials. All trials were reported in English. Of these, 21 employed re-randomization to determine optimal dosing, 8 for optimal dose-scheduling, 3 for salvage therapy, 0 for estimating disease modifying effects, 24 as direct comparison trials, as standard efficacy trials--that did not require re-randomization, and 3 as withdrawal of treatment trials. The median sample size of the period prior to re-randomization is 180 [interquartile range (IQR) 83-480] and after re-randomization is 104 [IQR 36 to 246]. Studies lost a median of 8% of eligible patients from period 1 to period 2 [IQR 0 to 17]. Studies were published between 1975 and 2005, with the vast majority (71%) published since 1995. The findings of our review indicate that trials employing re-randomization are relatively rare, have poor reporting of important methodological features, and, in some circumstances, fail to take advantage of the benefits that re-randomization can permit. PMID: 17067857

Author

Mills EJ, Kelly S, Wu P, Guyatt GH.

Citedate

2007-01-01

Citation

Contemp Clin Trials. 2007;28(3):268-75.

Affiliations

McMaster University

Taxonomy

Research Methodology

Guidelines to case report writing for naturopathic doctors

Anonymous — Tue, 24 Aug 2021 15:41:57 +0000

Guidelines to case report writing for naturopathic doctors Anonymous (not verified) Tue, 08/24/2021 - 11:41

Case reports play an important role in disseminating information to the medical community. Given the wide variety of naturopathic clinical practice, case reports offer an excellent opportunity to share clinical insights from naturopathic doctors. Typically, unique and rare events or patterns are depicted regarding different aspects of a case, including: symptomatology, pathophysiology, treatment(s), and outcome, including adverse effects. In this paper we elaborate on what a case report is, why one is conducted, and provide a brief set of guidelines on how one is written. We hope to encourage clinicians to write case reports and to submit them for publication. The case report is a well-respected venue for sharing valuable knowledge and generating questions derived from practice. The production of this form of clinically relevant evidence should be actively encouraged within the naturopathic community.

Author

Leung B, Seely D.

Citedate

2009-01-01

Citation

International Journal of Naturopathic Medicine. 2009 June;(4) 1:50-4

Affiliations

91��

Taxonomy

Research Methodology

Describing reporting guidelines for health research: a systematic review.

Anonymous — Tue, 24 Aug 2021 15:41:56 +0000

Describing reporting guidelines for health research: a systematic review. Anonymous (not verified) Tue, 08/24/2021 - 11:41

OBJECTIVE: To describe the process of development, content, and methods of implementation of reporting guidelines for health research. STUDY DESIGN AND SETTING: A systematic review of publications describing health research reporting guidelines developed using consensus. RESULTS: Eighty-one reporting guidelines for health research were included in the review. The largest number of guidelines do not focus on a specific study type (n=35; 43%), whereas those that do primarily refer to reporting of randomized controlled trials (n=16; 35%). Most of the guidelines (n=76; 94%) include a checklist of recommended reporting items, with a median of 21 checklist items (range: 5-64 items). Forty-seven (58%) reporting guidelines were classified as new guidance. Explanation documents were developed for 11 (14%) reporting guidelines. Reporting-guideline developers provided little information about the guideline development process. Developers of 50 (62%) reporting guidelines encouraged endorsement, most commonly by including guidelines in journal instructions to authors (n=18; 36%). CONCLUSIONS: Reporting-guideline developers need to endeavor to maximize the quality of their product. Recently developed guidance is likely to facilitate more robust guideline development. Journal editors can be more confident in endorsing reporting guidelines that have followed these approaches.

Author

Moher D, Weeks L, Ocampo M, Seely D, Sampson M, Altman DG, Schulz KF, Miller D, Simera I, Grimshaw J, Hoey J.

Citedate

2011-01-01

Citation

J Clin Epidemiol. 2011 Jul;64(7):718-42.

Affiliations

Ottawa Hospital Research Institute

Taxonomy

Research Methodology

Assessing the utility of an electronic research database to capture whole systems practice at two naturopathic outpatient teaching clinics

Anonymous — Tue, 24 Aug 2021 15:41:55 +0000

Assessing the utility of an electronic research database to capture whole systems practice at two naturopathic outpatient teaching clinics Anonymous (not verified) Tue, 08/24/2021 - 11:41

This observation study assessed the utility of an electronic Naturopathic Patient Database at 2 naturopathic teaching clinics as a research and educational tool. Focusing on the whole systems practice of naturopathic medicine using individualized treatment protocols, patients from the 91�� outpatient teaching clinic and the Boucher Institute of Naturopathic Medicine outpatient teaching clinic were assessed. Data were collected on patient demographics, laboratory values, physical measures, treatment protocols, and validated questionnaires. Results showed the Naturopathic Patient Database was able to capture both standardized and individualized measures of care for research purposes. A number of substudies were generated by student interns using the database. Limitations identified included limited resources for training faculty, interns, and administrators on program use and data entry; also, data quality and completeness were problematic. However, the Naturopathic Patient Database captured data on the individualized nature of naturopathic care and had the ability to collect and compare large amounts of data.

Author

Leung B, Flower G, Cooley K, Habib C, Gowan M, Podgrabinski S, Seely D

Citedate

2012-01-01

Citation

Journal of Evidence-Based Complementary & Alternative Medicine. Published online before print December 26, 2012, doi: 10.1177/2156587212470139

Affiliations

Boucher Institute of Naturopathic Medicine, The 91��, The Ottawa Integrative Cancer Centre, OM Corporation

Taxonomy

Research Methodology

Evaluation of the Cochrane Collaboration's tool for assessing the risk of bias in randomized trials: focus groups, online survey, proposed recommendations and their implementation

Anonymous — Tue, 24 Aug 2021 15:41:53 +0000

Evaluation of the Cochrane Collaboration's tool for assessing the risk of bias in randomized trials: focus groups, online survey, proposed recommendations and their implementation Anonymous (not verified) Tue, 08/24/2021 - 11:41

BACKGROUND: In 2008, the Cochrane Collaboration introduced a tool for assessing the risk of bias in clinical trials included in Cochrane reviews. The risk of bias (RoB) tool is based on narrative descriptions of evidence-based methodological features known to increase the risk of bias in trials. METHODS: To assess the usability of this tool, we conducted an evaluation by means of focus groups, online surveys and a face-to-face meeting. We obtained feedback from a range of stakeholders within The Cochrane Collaboration regarding their experiences with, and perceptions of, the RoB tool and associated guidance materials. We then assessed this feedback in a face-to-face meeting of experts and stakeholders and made recommendations for improvements and further developments of the RoB tool. RESULTS: The survey attracted 380 responses. Respondents reported taking an average of between 10 and 60 minutes per study to complete their RoB assessments, which 83% deemed acceptable. Most respondents (87% of authors and 95% of editorial staff) thought RoB assessments were an improvement over past approaches to trial quality assessment. Most authors liked the standardized approach (81%) and the ability to provide quotes to support judgements (74%). A third of participants disliked the increased workload and found the wording describing RoB judgements confusing. The RoB domains reported to be the most difficult to assess were incomplete outcome data and selective reporting of outcomes. Authors expressed the need for more guidance on how to incorporate RoB assessments into meta-analyses and review conclusions. Based on this evaluation, recommendations were made for improvements to the RoB tool and the associated guidance. The implementation of these recommendations is currently underway. CONCLUSIONS: Overall, respondents identified positive experiences and perceptions of the RoB tool. Revisions of the tool and associated guidance made in response to this evaluation, and improved provision of training, may improve implementation.

Author

Savovic J, Weeks L, Sterne JA, Turner L, Altman DG, Moher D, Higgins JP

Citedate

2014-04-15

Citation

Syst Rev. 2014 Apr 15;3:37

Affiliations

University of Bristol

Publication

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4022341/

Taxonomy

Research Methodology

Establishing an international research collaborative for naturopathy: The International Research Consortium of Naturopathic Academic Clinics (IRCNAC)

Anonymous — Tue, 24 Aug 2021 15:41:52 +0000

Establishing an international research collaborative for naturopathy: The International Research Consortium of Naturopathic Academic Clinics (IRCNAC) Anonymous (not verified) Tue, 08/24/2021 - 11:41

Naturopathy is a system of health-care through which practitioners apply core philosophies, theories and principles to integrate medical knowledge with natural treatment options. In recent years the naturopathic community has developed a stronger international coherence. Alongside this growing connectivity in the global naturopathic profession, there have been a number of calls for more systematic research attention to be devoted to naturopathy as a substantive research topic, as well as a need for the naturopathic profession to hone a culture of research and evidence-based practices and skillsets. Progress in this area has been made through the development of more pragmatic and whole systems naturopathic research. One aspect which is currently missing in the global naturopathic research landscape despite this growing pattern of practice-based, whole systems research is the application of international multicentre research projects. In response, we have established a research consortium for naturopathic academic clinics in four countries and across multiple world regions. This paper serves to overview the mission, scope and membership of the research consortium and explore some of the research designs and questions which it may support.

Read the full study.

Author

Amie Steel, Joshua Goldenberg, Kieran Cooley

Citedate

2017-10-10

Publication

Advances in Integrative Medicine

Taxonomy

Research Methodology