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Enquiry Service Proposal Workshop Monday 10 October, Lister Institute, Edinburgh Steve Turner Senior Researcher Dental Health Service Research Unit University.

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Presentation on theme: "Enquiry Service Proposal Workshop Monday 10 October, Lister Institute, Edinburgh Steve Turner Senior Researcher Dental Health Service Research Unit University."— Presentation transcript:

1 Enquiry Service Proposal Workshop Monday 10 October, Lister Institute, Edinburgh Steve Turner Senior Researcher Dental Health Service Research Unit University of Dundee

2 Proposed pilot online enquiry network for primary care staff  Linked to e-library  Collaborative – sharing workload and expertise  Based on CHPs or sample of practices  Service : enquiry answering and user education  Online – ? Web-based? Both?  £20K  A Pilot – implications?  Implementation research design

3 Implementation research  investigation into the efficiency and efficacy of different methods of promoting evidence-based practice (Walker et al, 2000).  selection of subjects  nature of the intervention  Outcome measures  unit of analysis ( treatment-patient-practitioner- practice)

4 Why do research?  Enthusiasm for practice  Increase evidence base for practice  Improve patient care and outcomes  It’s stimulating and creative  It’s career-enhancing

5 Proposed pilot online enquiry network for primary care staff  Linked to e-library  Collaborative – sharing workload and expertise  Based on CHPs or sample of practices  Service : enquiry answering and user education  Online – ? Web-based? Both?  £20K

6 Core components of research proposals Make sure that these are meaningful, not mechanistic

7 Core components (part1) Abstract Description of the research question An indication of why the problem is important Review of relevant literature Description of the proposed methodology (intervention and evaluation) Time frame (Gantt chart)

8 Defining the research question A broad research area is not a research question Formulate a number of possible questions, and weigh up the pros and cons The proposal must show that the issues have been thought through

9 Pinning things down “How feasible and effective is an online enquiry service in Primary Care?”

10 Pinning things down

11 Pinning things down (cont.) Restrict to General Practice? Internet availability for all practice team Define effectiveness Define feasibility Limit to disease/client groups?

12 Pinning things down: the revised research question “What is the impact of an online enquiry service for General Practice in terms of practitioner use, satisfaction and reported patient outcome, and how do these outcomes relate to costs?”

13 The literature review Provides a conceptual framework for the research Provides an integrated overview of the field of study Helps establish a need for the research May help clarify the research problem Helps to demonstrate researcher’s familiarity with the area under consideration (theory and / or methods)

14 Methodology  Is any pilot work needed?  Validation of tools  Sample size calculation if appropriate  Feasibility study of proposed recruitment strategies / processes

15 Methodology  Quantitative/qualitative/mixed?  What are the outcomes of interest?  Is it do-able?  Can outcomes be measured?  Adequate access to samples?  Resources likely to be available?

16 Methodology Cost analysis –Overall costs –Unit costs per completed enquiry –Implementation costs Recruitment of practices –Random Sample –Purposive Sample –S.P.I.R.R.e. (S.S.P.C.)

17 Scottish Practices and Professionals Involved in Research (SPPIRe) Aims to "increase the amount of research relevant to patient care undertaken in a primary care setting". National primary care research framework operating in Scotland under the auspices of the Scottish School of Primary Care, with funding from the Chief Scientist Office in Scotland. Helps link researchers with professionals in primary care who can host or otherwise support high quality research projects of relevance to primary care.

18 SPPIRe has three principle functions: to develop and maintain a dynamic register of research interested practices and professionals willing to participate in research, either as hosts or as more active participants; to 'translate' research requests and protocols into workable procedures for primary care professionals and ensure that commitment is maintained; To rationalise the number of requests to professionals and practices to undertake research through either national or regional systems.

19 Core elements 2 Budget Description of how findings will be disseminated Outline of team members’ expertise (CVs) and responsibilities Capacity development Ethical statement Possible problems Other information specified by funders

20 What resources will be needed?  Detailed and accurate costings  Realistic timescale  Who will do the work?  Who will be the sponsor for the project?  Will all legal requirements be covered?  Support for Science if appropriate

21 Collaboration Do we have the right skill mix to develop the project? Invite collaborators with complementary skills Decide on division of how responsibilities and roles Identify any gaps in expertise

22 Producing a successful proposal

23 CSO checklist for assessing outline applications (1) Introduction Establishes the importance of the topic? Clear account of what is already known? Background information relevant and specific to the aims of the study? Clear what search strategy was used? Aims and Research Questions Clear? Relevant (to improving population health or healthcare)? Answerable? Are they research questions?

24 CSO checklist for assessing outline applications (2) Plan, Methods, Expertise Available Research design appropriate to the research aims and questions? Methods clearly described? Size of the study well justified? Clear and realistic recruitment strategy? Analysis plan appropriate to the data? Necessary expertise and experience? Feasible with the resources requested? Research Outcomes Suggestions for implementing the results clear and realistic?

25 What do funders want to see? Clearly defined research question Appropriate literature provides a background to the problem Use of other sources to identify/support the problem Objectives clearly specified Conceptual framework and theoretical assumptions clearly stated Appropriate design and methodology Promotes further research Preliminary data/pilot study Necessary resources available

26 What don’t funders want to see? Too long Poor structure, language use Inappropriate use of technical terms Research too ambitious Literature review inadequate or not original No integration of theory in literature review Budget not linked to methodology Unrealistic costing Methods not clear Methods inappropriate No references or bibliography

27

28 Check out these services Clinical Effectiveness Enquiry Service UCL ATTRACT PC enquiry service in Wales (BMJ 2001;322; ) Relevant features Service aims? How evaluated? How successful?

29 1.The ATTRACT Process Clinician sends query to ATTRACTsends query Researcher receives question and seeks clarification if necessary Analyses terms- looks for synonyms, general classifications and MeSH terms- then devises a search strategysearch strategy Searches abstracts of evidence based literature in accordance with the following hierarchy of sources: –Cochrane Library –Clinical Evidence (BMJ) –TRIP database including searching via clinical queries on PubMed If a recent (less than 2 yrs old) systematic review answers the query, the search terminates. If no recent evidence from the core sources then Medline (via OVID or PubMed) and EMBASE searched. The research literature is appraised according to the standard EBM "Hierarchy of Evidence" and summarised.EBM "Hierarchy of Evidence" A hardcopy of the summary and printouts of relevant research abstracts sent to the clinician who asked the question.sent to The summary uploaded onto ATTRACT website as an answer to the question, categorised by subject area, and strength indicated.

30 UCL Clinical Effectiveness Enquiry Service –Literature searching on demand - with or on behalf of Royal Free staff –Information or evidence sought to inform: individual patient care – general patient care (CPD) – guideline development – teaching and presentations – publication – research – audit – –Access - in-person, by telephone, , fax, intranet

31 UCL Clinical Effectiveness Enquiry Service Consultant telephones for literature search to find any evidence on the treatment of Lassa fever → search is carried out and references ed to the consultant → he selects 7 articles →2 provided from stock, 5 articles are ‘urgent action’ inter-library loaned from the BL → articles are hand delivered to the consultant the following morning = patient is discharged.

32 * Incomplete data [ 2002 ] [ 2003 ]

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34 CEES time line 2002 Clinical and Research Governance Support Librarian in post CEES launch Retrospective user survey Intranet submission 2003 Peak in users (52 in Jan) TODAY Launch of RNTNEH Clinical Librarian pilot Library Newsletter ‘helping you achieve Clinical Governance’ CHI visit Nurses and Midwifery Forum Floor walk Physiotherapy Dept. Palliative Care Service Group UCL Clinical Research Network Information Fair Clinical Audit and Effectiveness Committee (CAEC) Clinical Practice Group (CPG) RNTNEH Report on CEES Clinical audit skills CAEC Cochlear Implant Group Stroke prevention guidelines RNTNE Service Group CPG NoCTeN Nuffield speech team Managing life in the NHS Library Committee 11 th June 25 th July CAEC Clinical governance working group (CGWG) J F M A M J J A S O N D Welcome (new doctors) Occupational Therapy Dept. Occupational Therapists (Musculoskeletal) CGWG CAEC Library Newsletter Medical Library link on front page of Freenet (Trust intranet) 12 month pilot giving clinicians free full text of electronic resources available to CRGSL Letter to all Clinical Heads of Service; presentation to coincide with NeLH Awareness week initiative

35 Resources used to problem solve Dentists; GPs (Taylor et al ) Never Rarely Occasionally Often Very often

36 Remember  All the evidence to support your application must be included on the form  Do not assume that the funder will know the worth of your area of research  Will be judged on the basis of the whole package  Be clear and concise

37 Your aim should be for:  Clarity  Value  Relevance  Ta-ra factor  Solid question  Robust proposal  Useful results

38 Resources  EASTREN website  SSPC website and advice  University of Michigan Proposal Writer's Guide by Don Thackrey

39 If you get the money…  Ethical approval  Trust Management R&D approval  If Scotland-wide, register as SPPIRe project Thanks to Marie Pitkethly, EastRen Co-ordinator


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