1. Research Methods & Study Design

2. What is research?? A search for knowledge
An art of scientific investigation
An academic activity and as such the term should be used in a technical sense.

3. RESEARCH APPROACHES Many research projects combine a
number of approaches, e.g. may
use both quantitative and
qualitative approaches

4. Quantitative research
The emphasis of Quantitative research is on collecting and analysing numerical data; it concentrates on measuring the scale, range, frequency etc.

5. Comparison: Quantitative vs. Qualitative Research:
Quantitative Methods:
Formulate hypothesis
Observe events/present questionnaire with fixed answers.
Tabulate responses
Summarize data
Analyze and draw
conclusions
Qualitative Methods:
Observe events and/or ask questions with open-ended answers.
Record observations
Interpret observations
Return for new and refined observations
Review data and draw conclusions
Formulate hypothesis or theory

6. Qualitative research
Qualitative research is more subjective in nature than Quantitative research and involves examining and reflecting on the less tangible aspects of a research subject, e.g. values, attitude, perceptions.

7. Determining the Research Approach
Use quantitative if your research problem requires you to
Measure Variables
Assess the impact of these variables on an outcome
Test existing theories or broad explanations
Apply results to a large number of people
Use qualitative if your research problem requires you to
Learn about the views of the people you plan to study
Assess a process over time
Generate theories based on participant perspectives
Obtain detailed information about a few people or research sites.  

8. Type of Study Design Two factors characterized a study design: Time
Intervention

9. Time Perspectives Cross-sectional Retrospective Prospective
Only look at present situation
Retrospective
Describe events in the past
To relate a present condition to a factor that took place in the past
Prospective
Study objects are followed over time

10. Study Design Categories
Non-intervention
Exploratory
Descriptive
Analytical / Comparative
Case-control
Cohort
Intervention
Experimental
Quasi-experimental

11. Types of Study Design Descriptive Case-Control Cohort Experimental
Quasi-experimental

12. Analytical / Comparative
Study Design
Study Design
Non-intervention
Exploratory
Descriptive
Analytical / Comparative
Case-control
Cohort
Intervention
Experimental
Quasi-experimental

13. Study Design Exploratory studies
is a small-scale study of relatively short duration, which is carried out when little is known about a situation or a problem.
It may include description as well as comparison.

14. Study Design Descriptive studies
involves describing the characteristics of a particular situation, event or case.
to answer WHAT , WHERE, WHEN and HOW

15. Descriptive
Involves the systematic collection and presentation of data to give a clear picture of a particular situation
Aims at defining “what is the problem?” and seek to explore and identify various factors associated with the problem.

16. Descriptive
Derives:
Prevalence rates
Association between variables

17. Descriptive Advantages Disadvantages Relatively cheap to conduct
Relatively quick to carry out
Captures the situation at only one point in time
Unable to show
causal relationship

18. DIRECT CAUSAL RELATIONSHIP
INDIRECT CAUSAL RELATIONSHIP
COMPLEX CAUSAL MODEL
INCOME LEVEL
SEX
INCOME LEVEL
SEX
EDUCATION LEVEL
OCCUPATION
EDUCATION LEVEL
OCCUPATION
INCOME LEVEL
SEX
FAMILY RESPONSBILITY
PART TIME WORK

19. Descriptive Examples: Nutritional Study Prevalence of TB with AIDS
National Health and Morbidity Survey 3 (NHMS3)
Qualitative Study – research using Focused Group Discussion (FGD)
Study of young people's awareness with tobacco marketing

20. Study Design Comparative or analytical studies
An analytical study attempts to establish causes or risk factors for certain problems. This is done by comparing two or more groups, some of which have or develop the problem and some of which have not.

21. Study Design Example of small-scale studies:
Two district health teams (DHT) that are functioning well and two that do not function satisfactorily, in order to detect the possible reasons for bottlenecks in the functioning of the district health teams;
One community with high and another with low participation in health activities, in order to identify factors that contribute to community participation;
20 mothers who delivered in a maternity and 20 who delivered at home, in order to identify possible reasons for the low percentage of supervised deliveries

22. Comparative or analytical studies
Study Design
Non-intervention
Exploratory
Descriptive
Comparative/ Analytical
Case-control
Cohort
Intervention
Experimental
Quasi-experimental

23. Case-control
Study design that one group which has a particular characteristic/disease (case) with another group without the characteristic/ disease (control) in order to find out what factors have contributed to that characteristic /disease
Matched on certain variables but not on which one expects to cause the problem
Usually use historical (retrospective) data

24. Case-control PAST PRESENT (Retrospective study , looking backward)
Risk factor present
CASES
Risk factor absent
COMPARE
Risk factor present
CONTROLS
Risk factor absent

25. Case-control Derives: Odd ratios Cause-effect relationships Case Not
A measure of association.
It is the ratio of the risk of disease in an exposed population to that in unexposed.
Odds ratio = (a/c)
(b/d)
= ad/bc
Where,
Control
Exposed Not
Exposed
Exposed a b
Case Not
Exposed c d
Derives:
Odd ratios
Cause-effect relationships

26. Case-control Advantages Disadvantages Relatively cheap to conduct
Relatively quick to carry out
Able to show causal relationship
Dependant on the availability and quality of existing data
There might be difficulty in matching the cases
Selective survival might bias the comparison
Unable to calculate incidence rates

27. Case-control Examples: Cancer Aetiological study
Hepatitis B and Hepatoma study
Study of the relation between sinusitis and subsequent risk of multiple sclerosis

28. Cohort
Study in which subjects, initially disease free, are followed up over a period of time. Some will be exposed to some risk factor, while some will not.
A prospective study

29. Not exposed to risk factor
Cohort
PRESENT
FUTURE
(Prospective study , looking forward)
Problem present
Exposed to risk factor
Problem not present
COMPARE
Problem present
Not exposed to risk factor
Problem not present
(Source: Holland et all., 1985)

30. Cohort Derives: Relative risk Cause-effect relationships
It is the ratio of the incidence rates in an exposed population to that in unexposed.
Relative risk = Incidence among exposed
Incidence among unexposed
= a/(a+b)
c/(c+d)
Where,
Disease Status
Exposed Not
Exposed
Risk Exposed a b
Factor Not
Status Exposed c d
Derives:
Relative risk
Cause-effect relationships

31. Cohort Advantages Disadvantages
Able to show the characteristic preceded the disease
Can establish cause-effect relationships
Able to disclose other diseases related to the same risk factor
It is a costly study
Not always feasible
Lost of subjects during follow-up
Require large sample size

32. Cohort Examples: Smoking and Lung Cancer “Birth Cohorts” Study
Longitudinal Study of Aging

33. Analytical / Comparative
Study Design
Study Design
Non-intervention
Exploratory
Descriptive
Analytical / Comparative
Case-control
Cohort
Intervention
Experimental
Quasi-experimental

34. Experimental Research designs "gold standard“
Most “rigorous” of all research designs
Provide cause-effect inferences
Need:
Randomization
Control and treatment group
Intervention

35. Experimental

36. Experimental Can obtain: Cause-effect relationships
Evaluation of the intervention

37. Experimental Advantages Disadvantages
Useful in clinical/laboratory research
Able to test cause-effect relationships
Do not require large sample size
It is an expensive study
Ethical issues
Difficult to conduct in a community-based research

38. Experimental Examples: Clinical / Drug Trial
A Mental Health Experimental Study

39. Quasi-experimental “Quasi” = ‘as if’ or ‘almost’
Quasi-experimental design is a form of experimental research used extensively in the social sciences and psychology
“Quasi” = ‘as if’ or ‘almost’
Either no randomization or control group

40. Quasi-experimental Advantages Disadvantages
Able to test cause-effect relationships
Useful for evaluation of intervention in the community
It is an expensive study
Ethical issues

41. Quasi-experimental Examples:
To perform an educational experiment, a class might be arbitrarily divided by alphabetical selection or by seating arrangement.
The experiment proceeds in a very similar way to any other experiment A variable being compared between different groups, or over a period of time.

42. Other design
Systematic review
Meta-analysis

43. Systematic review
A systematic review is a comprehensive survey of a topic that takes great care to find all relevant studies of the highest level of evidence, published and unpublished, assess each study, synthesize the findings from individual studies in an unbiased, explicit and reproducible way and present a balanced and impartial summary of the findings with due consideration of any flaws in the evidence.
In this way it can be used for the evaluation of either existing or new technologies and practices.

44. Systematic review

45. Meta-analyses
Meta-analysis is a systematic, objective way to combine data from many studies, and arrive at a pooled estimate of treatment effectiveness and statistical significance.
Meta-analysis can also combine data from case/control and cohort studies.
The advantage to merging these data is that it increases sample size and allows for analyses that would not otherwise be possible.
They should not be confused with reviews of the literature or systematic reviews.

46. Meta-analyses

47. QUESTIONS???

48. THANK YOU