HEALTHCARE RESEARCH METHODS: The Research Question, The research team The study approaches

1. PHC215
By Dr. Khaled Ouanes Ph.D.
E-mail: k.ouanes@seu.edu.sa
Twitter: @khaled_ouanes
INTRODUCTION TO
HEALTHCARE RESEARCH
METHODS

2. Focusing on the Research
Question

3. Primary, Secondary, and Tertiary
Research

4. Key Considerations

5. Study Goals & Specific Objectives
The literature review and consideration of a study
approach should lead to the selection of one very
specific study topic that can be stated in terms of a
single overarching study goal or study question.
A study goal often includes the specific exposure,
disease, and population that will be the focus of the
study

6. Examples of Study Goals

7. After finalizing the overarching study goal, the researcher
should identify three or more specific objectives (also
called specific aims or specific hypotheses) that stem from
the main study goal.
 Each of these specific objectives should take the form of
a measurable question or a “to” statement.
 Each should represent a logical step toward answering
the main study question.

8. Example
Study goal: “to assess the impact of lead
poisoning on school performance in
kindergarten students in USA.”
Specific objective #1:
1. To measure the prevalence of high blood lead levels in a
random sample of kindergarten students in USA.

9. Example
Study goal: “to assess the impact of lead
poisoning on school performance in
kindergarten students in USA.”
Specific objective #2:
2. To determine whether children in that sample with high
blood lead levels have lower scores on academic tests
than children with lower blood lead levels.

10. Example
Study goal: “to assess the impact of lead
poisoning on school performance in
kindergarten students in USA.”
Specific objective #3:
3. To estimate the total impact of high blood lead levels on
kindergarten performance in USA by applying the rates in
the sample population to the total population of the
region / Country.

11. Example
Note that all three of these
specific objectives relate to the
overall study goal and provide a
clear pathway for achieving the
main goal.

12. ESSENTIAL QUESTIONS TO THE
SUCCESS OF THE PROJECT

13. ESSENTIAL QUESTIONS TO THE
SUCCESS OF THE PROJECT

14. Assembling a Support
Team

15. Research projects benefit from the
input of technical and cultural experts.
A team of collaborators should be
assembled early in the research
process.

16. Members of the Team

17. Although some papers in the health
sciences have solo authors, most
papers have about four coauthors,
and some have dozens of coauthors.

18. All of what we have seen until now in the
previous presentations is about the 1st step:
Identifying a Study Question

19. Selecting a Study
Approach

20. The 2nd step: Selecting a Study Approach

21. Overview
The 2nd step in the
research process is
to select a general
study approach.
This section
provides an
overview of 8
common study
designs.
1. Reviews / meta-analyses
2. Correlational (ecological)
studies
3. Case series
4. Cross-sectional surveys
5. Case control studies
6. Cohort studies
7. Experimental studies
8. Qualitative studies

22. The Studies Approaches

23. Primary,Secondary,
andTertiaryStudy
Approaches

24. Study duration
Primary Studies:

25. Study duration
Secondary & Tertiary Studies:
The study duration is dependent on how existing
data & articles will be acquired.

26. Population Selection for Each
Study Approach

27. REVIEWS

28. A review article or meta-analysis carefully gathers
all prior publications on a specific topic and
summarizes them to provide a big-picture
analysis.
Meta: meaning "after", or "beyond") is a prefix used in
English to indicate a concept which is an abstraction from
another concept, used to complete or add to the latter.

29. The required Steps:
1. An extensive search of the literature
2. Extraction of key information from relevant
articles
3. Clear and concise presentation of this
information

30. The benefits:
 A literature review is an effective way to become an
expert in the literature on a well-defined topic
 A literature review is a helpful step in preparing for future
primary or secondary analyses
 Review articles are often cited more often than reports
of individual field studies

31. The limitations and drawbacks:
 Not all journals publish review articles (especially reviews
that the editors do not solicit)
 Reviews are sometimes perceived to be a less rigorous
form of research than projects that collect new data
and/or involve statistical analysis

32. Selecting a Topic
The most important decision is to select a topic
that is narrow enough that all the relevant
publications can be acquired.
The topic may need to be modified after a
preliminary search, depending on the number of
articles available.
Example:
 9 = too few  expand the scope
 100+ = too many  narrow the scope

33. Library Access
 The full text of every relevant article must be identified
and obtained.
 Check with a university librarian about the library’s
policies and the fees that may be charged for the use
of interlibrary loan services.
 Maintain a meticulous system for tracking articles that
have already been acquired, those that have been
requested but not yet received, and those that need
to be requested.

34. Narrative Reviews
Narrative reviews tell a “story” about a well-
defined topic using evidence from the literature
to support the “plot”
Narrative reviews must be carefully organized
by theme, methodology, chronology, or some
other guiding principle
The absence of a systematic search strategy
must be justified by the researcher

35. Systematic Reviews
 Systematic reviews are designed to minimize the bias
that might occur when review article authors handpick
the articles they want to highlight
 After the identification of the study question, the most
important decision in a systematic review is the
selection of keywords and inclusion criteria
 The goal is to craft a search strategy that identifies all
the articles ever published on the narrow, well-defined
area covered by the review

36. Once the articles are identified from one or
more abstract databases, each article is
screened to see whether it is eligible for
inclusion.
Relevant information is extracted from all
eligible articles and presented in table form.
Then the trends and key observations are
summarized.
Systematic Reviews

37. SystematicReviews

38. Meta-Analysis
The goal of a meta-analysis is to combine the
results of several high-quality articles that used
similar methods to collect and analyze data
into one summary statistic.
Meta-analysis usually begins with a
comprehensive systematic review of the
literature to identify every single possibly
relevant article.

39. The steps of a meta-analysis are to:
 Conduct a systematic review
 Assess the quality and comparability of each eligible study
 Extract statistical results from each study that meets all
inclusion criteria
 Combine these statistical results into one summary statistic
Meta-Analysis

40. Key Characteristics of Reviews and Meta-
Analyses

41. Key
Characteristics
of Reviews and
Meta-Analyses

42. PHC215
By Dr. Khaled Ouanes Ph.D.
E-mail: k.ouanes@seu.edu.sa
Twitter: @khaled_ouanes
HEALTHCARE RESEARCH METHODS
Based on the textbook of introduction to health research methods – K.H. Jacobsen