1. RESEARCH METHODS Dr. Shamanthakamani Narendran M.D.(Pead), Ph.D. (Yoga Science) How What Why ?

2. INTRODUCTION Nowadays there is an increasing interest in using non pharmacological (alternative) modes for ailments which are known to be caused by stress induced changes in the mental state. However, though there are not yet accepted by the medical community, in India or elsewhere. For this reason the clinical progress has to be systematically monitored, using methods which are acceptable the world over.

13. Planning a research project Ask a question? Literature FREQUENT REVIEW Data taking Design Parameters available /not Data analysis Question answered Report/ Ask next question Y N Y N

21. In this way at the end of the study you have data collected on large numbers of patients in two groups, who have not been ‘matched’ already. At this stage, keeping the selected criteria in mind, patients in the groups may be matched and the data used for analysis. Of course there will be patients in both groups whose age/duration of illness, etc., does not exactly match that of any patient in the other group. These data cannot be used for analysis. The first method – of matching patients first and then randomly assigning one of the pair to either group, is best suited to a situation wherein a fixed number of patients are beginning treatment at the same time.

23. In studies making use of ‘alternative’ therapies, another question becomes important. Most of these treatments are thought to bring about their therapeutic benefit by modifying the functioning of the mind. For this reason a very important factor is motivation . In psychosomatic ailments especially, feeling optimistic would definitely, hasten recovery. It is obvious that patients in the ‘treatment’ group would have motivation. The main difficulty with the control group is that it is difficult to have subjects who are motivated to receive alternative therapy, but who are not actually receiving the treatment.

24. A possible solution is to design a study to compare the effects of two alternative therapies, so that – for example – one group receives yoga therapy, while the other group receives naturopathy treatments. Sometimes this may not be possible. Another alternative may be to compare two types of yoga (or naturopathy) treatments. In such a study, one group of patients may be given relaxing and slowing down practices, while the other group practices ‘stimulating’ practices. In all cases an important issue is assigning subjects to either group . This is best done randomly .

26. The type of design is a random matched controlled study. Most studies which are done on medicine are double blind and placebo controlled . These two terms refer to additional checks which are used to make the results as free of bias as possible. Double blind means that both the subjects and the experimenter are not aware of the treatment which has been given to the subject. This may be done in different ways. The common method for a trial on tablets is to use two tablets which look identical. One of them is the actual , medically active drug, while the other may be a ‘harmless pill’, which has not physiological effects.

27. The harmless pill is called a placebo . In a double blind study neither the patient nor the experimenter would know whether the tablet given was a placebo or not. This information would be kept by another person, to be used in the final interpretation of the results. This design reduces the bias of both the patient and the experimenter. With some of the non pharmacologic treatments, however, it is usually not possible to have a double blind, placebo controlled study. The reason is that these treatments usually require the active participation of the patient. For example, a patient who is practicing asanas cannot be unaware that he is doing so. Also there is no question of there being a placebo for it.

29. Some studies also introduce the cross over design. This would mean that the two groups would receive two different treatments for a fixed period. At the end of this period the groups would ‘swap’ treatments. Assessments would be made at least thrice, i.e., (1) in the beginning, (2) at the end of the first phase and before swapping, and (3) at the end of the second phase . This may be useful to compare the effects of two treatments on the same individual, and also to verify whether the order of giving the treatments influences the results.

30. STATISTICS Statistical assessments are necessary to be able to understand whether the results obtained in a group of patients are of significance, and can be generalized to the general population. Before discussing the actual statistical tests a few definitions are needed. MEAN MEDIAN MODE + + + + Divided by 5 Arithmetic mean Midway, in ascending order Most frequent STATISTICAL AVERAGES

34. Statistical tests may be carried out for two reasons. Choosing the Correct Statistical Test Examine the Data What is the question begin asked Homogenous Equal SD Heterogenous Different SD Parametric Non Parametric Are the Two Sets Different? Are the Two Sets Correlated? Set “a” Set “b”

35. Two Sets of Statistical Tests Statistical tests are two types, parametric and nonparametric . NONPARAMETRIC Spearman’s test PARAMETRIC Pearson’s test SET ‘b’ NONPARAMETRIC Wilcoxan’s test Mann Whitney test ANOVA (Kruskal – Wallis test) PARAMETRIC Paired t test t test (not paired) ANOVA (parametric) SET ‘a’

37. A set of numbers is said to have a normal distribution if most of the numbers cluster around a particular value . Numbers very much lower or much higher than this value are either absent from the sample, or very few. This is shown by a bell shaped curve. NORMAL DISTRIBUTION Number In Each Interval Frequency Intervals NORMAL DISTRIBUTION

38. Parametric tests are considered more powerful than nonparametric tests. Depending on which of the two questions are asked ( see below ), different tests are used. Question 1 – Are the two sets of values the same, or different. The tests which may be done are of two types as described above, viz. parametric and nonparametric . Question 2 – Are the two sets of data interrelated/correlated?

40. (b) Unpaired data . When two sets of independent data are to be compared, the tests which are used for related data or paired data are not appropriate. For such independent data which fulfill the conditions needed for parametric tests, a t test for independent data is used. Whereas for independent data which require nonparametric analysis, the Mann Whitney U test is suitable. (c) Comparing more than two sets of data . When more than two sets of data are to be compared, the Analysis of Variance (ANOVA) is used. Data which can be analyzed with parametric tests is analyzed with an ANOVA which is different from the nonparametric ANOVA used to analyze data which do not have a normal distribution and equal variances. The latter test is called Kruskal – Wallis test .

41. As described above, there are two separate tests for data which have equal variance and normal distribution – a parametric test and for data which do not have a normal distribution and with unequal variance, a nonparametric test . The former is called Pearson’s Rank Correlation test , while the nonparametric correlation tests is Spearman’s Rank Correlation test . The paragraphs above are intended to help the researcher to select which test should be used to analyze different data samples. The actual tests are not described here. They are described in most statistics textbooks, along with formulae, and the precautions to be taken. Question 2 – Are the two sets of data interrelated/correlated?

42. SUGGESTED READING Zar, J.H. (1984). Biostatistical Analysis . Second Edition. Prentice – Hall, New Jersey.

44. Overweight is when an individual exceeds the upper limit of the full range for his/her height and obesity is defined as a weight of 120% or more above the upper limit = 100%. The Body Mass Index (BMI) or Quetelet’s index is calculated from the equation – weight in kg divided by the square of the height measured in meters. A BMI of 30 or more in males, or 28.6 or more in females would be indicative of obesity . 3. Wrist circumference (in cm) is recorded using a tape measure horizontally beyond the wrist bone, where the wrist bends.

45. This is used to calculate the ratio between the height and wrist circumference (both in cm) to get an idea about body frame. If Height / Wrist circumference = r If r > 10.4 small frame (males) If r > 11.0 small frame (females) If r = 9.6-10.4 medium frame (males) If r = 10.1-11.0 medium frame (females) If r < 9.6 large frame (males) If r < 10.1 large frame (females)

55. WRITING IT UP Most reports on empirical research follow a standard format. Research on TESL and language acquisition is no exception. This format typically consists of five major sections, which may be subdivided into smaller parts. The five main components of a research report are...

59. LITERATURE REVIEW As part of the planning process you should have done a LITERATURE REVIEW , which is a survey of important articles, books and other sources pertaining to your research topic. Now, for the second main section of your research report you need to write a summary of the main studies and research related to your topic. This review of the professional literature relevant to your research question will help to contextualize, or frame, your research. It will also give readers the necessary background to understand your research.

60. Evaluating other studies: In a review of the literature, you do not merely summarize the research findings that others have reported. You must also evaluate and comment on each study's worth and validity. You may find that some published research is not valid. If it also runs counter to your hypothesis, you may want to critique it in your review. Don't just ignore it. Tell how your research will be better/overcome the flaws. Doing this can strengthen the rationale for conducting your research. Selecting the studies to include in the review: You do not need to report on every published study in the area of your research topic. Choose those studies which are most relevant and most important.

62. Another approach is to organize your review by argument and counter argument. For example, You may write about those studies that disagree with your hypothesis, and then discuss those that agree with it. Yet another way to organize the studies in your review is to group them according to a particular variable, such as age level of the subjects (child studies, adult studies, etc.) or research method (case studies, experiments, etc.).

63. The end of the review: The purpose of your review of the literature was to set the stage for your own research. Therefore, you should conclude the review with a statement of your hypothesis, or focused research question. When this is done, you are ready to proceed with part three of your research report, in which you explain the methods you used.

64. DESIGN & METHOD The DESIGN & METHOD section of the report is where you explain to your reader how you went about carrying out your research. You should describe the subjects, the instruments used, the conditions under which the tests were given, how the tests were scored, how the results were analyzed, etc. Remember that this section needs to be very explicit. A good rule of thumb is to provide enough detail so that others could replicate all the important points of your research. Failure to provide adequate detail may raise doubts in your readers' minds about your procedures and findings.

65. Make sure you are honest and forthright in this section. For example, if you had some problems with validity, acknowledge the weaknesses in your study so that others can take them into account when they interpret it (and avoid them if they try to replicate it).

66. RESULTS In the RESULTS of your report you make sense of what you have found. Here you not only present your findings but also talk about the possible reasons for those findings. Also, if your research approach was deductive, then here is where you accept or reject your hypothesis (based on your findings). In addition, in this section you should use your knowledge of the subject in order to make intelligent comments about your results.

67. BE CAREFUL! Sometimes researchers use this section as a soapbox and talk about things that don't have anything to do with the research that they did. Don't fall into this trap. Make sure your comments are related to (and based on) your research. Do not go beyond your data. Also, as you report and interpret your findings, do not exaggerate or sensationalize them. Nor should you minimize them. A straightforward matter-of-fact style is probably best.

69. ABSTRACT Some research reports end (or begin) with an abstract. An abstract is a highly abbreviated (usually 100-200 words) synopsis of your research. It should describe your rationale and objectives, as well as your methods and findings. Because of its limited length, an abstract cannot go into detail on any of these topics. Nor can it report on the limitations of your research or offer suggestions for future research. For those, readers will have to read the entire report. But, after reading your abstract, people unfamiliar with your research should know what it is about and whether they want to read the entire report.

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