RESEARCH DESIGN

Department of Epidemiology and Biostatistics 2010

Objectives
To understand the concepts of different study design To learn the advantages and disadvantages of several study design

Classification of Study Design

Types of study design

Quantitative Qualitative
Analytic Descriptive

Experimental

Non-experimental Observational

Grounded theory
Randomizes Clinical Trial Non-randomized Clinical Trial Phenomenology

Case report

Ethnography Cohort Case-control Cross-sectional

Quantitative research
a formal, objective, systematic process in which NUMERICAL DATA are utilized to obtain information about the world

Quantitative research
Is used to
- describe variables - examine relationships among variables

- determine cause- and-effect interactions between variables the predominantly used method of scientific
investigation

Qualitative research
a systematic, subjective approach used to describe life experiences and give them meaning not a new idea in social and behavioral sciences

Types of study design

Quantitative Qualitative
Analytic Descriptive

Experimental

Non-experimental Observational

Grounded theory
Randomizes Clinical Trial Non-randomized Clinical Trial Phenomenology

Case report

Ethnography Cohort Case-control Cross-sectional

Epidemiologic Study Design

Descriptive epidemiology:
Measure the frequency in which disease occur Collect descriptive data on possible causal factors

Analytic epidemiology
Specify the causes of particular disease

Types of study design

Quantitative Qualitative
Analytic Descriptive

Experimental

Non-experimental Observational

Grounded theory
Randomizes Clinical Trial Non-randomized Clinical Trial Phenomenology

Case report

Ethnography Cohort Case-control Cross-sectional

Types of Studies
Experimental: study factor is manipulated by the investigator
Pure vs quasi experimental Laboratory vs real world

Observational: no manipulation of study factor

Descriptive vs analytic Prospective vs retrospective

Types of study design

Quantitative Qualitative
Analytic Descriptive

Experimental

Non-experimental Observational

Grounded theory
Randomizes Clinical Trial Non-randomized Clinical Trial Phenomenology

Case report

Ethnography Cohort Case-control Cross-sectional

Cross-sectional Study
DM Obese (+) Obese (-)

Obese (+)

Obese (-)

Sample

Non dM

Population

Case control
Starting point

CONCLUSION

Exposure A

With disease

Exposure B

Without disease

Cohort
Starting point

Exposure A

With disease CONCLUSION

Exposure B

Without disease

Types of study design

Quantitative Qualitative
Analytic Descriptive

Experimental

Non-experimental Observational

Grounded theory
Randomizes Clinical Trial Non-randomized Clinical Trial Phenomenology

Case report

Ethnography Cohort Case-control Cross-sectional

Clinical Trial
Disease
Treatment Sample Population Placebo No No Yes
CONCLUSION

Random selection

Yes

Blinded administration

Time line of different study design

Cross Sectional

Case T i m e l i n e Report Case `Series Clinical Trial

Case Control

Cohort study

Types of Epidemiology Study

Type of study
Observational studies
Descriptive studies Analytical studies Ecological Cross-sectional Case-control Cohort

Alternative name

Unit of study

Experimental studies
Randomized controlled trial Field Trials Community Trials

Correlation Prevalence Case-reference Follow-up Clinical Trial Com.intervention study

Populations Individuals Individuals Individuals Patients Healthy people Communities

Application of Observational study design

Ecological Investigation of rare disease Investigation of rare cause Testing multiple effects of cause (eg hypertension) Study of multiple exposures and determinants (eg: AMI) Measurement of time relationship Direct measurement of incidence Investigation of long latent period ++ = degree of suitability - = not suitable ++++ ++ + ++ ++ Crosssectional ++ ++ Casecontrol +++++ ++++ +a +b +++ Cohort +++++ +++++ +++ +++++ +++++ -

a=if prospective b=if population-based

Selection of study design depends on: Research question/problem/objective Time & resources availability Common/rare disease Expected outcome Quality of data Established design

Choose the most appropriate design for each study title

Assessment of students health status using Treadmill

Choose the most appropriate design for each study title

Association between 3 months Treadmill exercise and students health status

Choose the most appropriate design for each study title

Association between lung cancer and smoking behavior.

Choose the most appropriate design for each study title

Distribution of bone-fracture location in patient with motorcycle accident admitted to Emergency Room, Hasan Sadikin Hospital.

Choose the most appropriate design for each study title

New emerging disease: Severe Acute pneumonia in children in urban area of Bandung.

Choose the most appropriate design for each study title

The effect of peer-education on students smoking cessation

Choose the most appropriate design for each study title

Protein concentration in several kind of peas

 Graduate:
Regular physician, Researcher, Pediatritian, Obstetritian, Surgeon, Internal medicine Jakarta, Bandung, Banjaran, Majalengka, Kuningan

Real Problem
Menkes dan Mendiknas 2010
Rasio dokter dengan jumlah penduduk Penyebaran dokter tidak merata, kabupaten masih kekurangan dokter, terutama daerah terpencil

Many researchers have narrowly defined scientific research method to include only quantitative research. This research method is based on the philosophy of logical empiricism

 Qualitative researchers aim to gather an in-depth understanding of human behavior and the reasons that govern such behavior. The qualitative method investigates the why and how of decision making, not just what,where, when. Smaller but focused samples are more often needed, rather than large random samples.

Qualitative research

Qualitative research
seeks TO UNDERSTAND a given research problem or topic from the PERSPECTIVES OF THE LOCAL POPULATION it involves.
Qualitative research is especially effective in obtaining culturally specific information about the values, opinions, behaviors, and social contexts of particular populations

What can we learn from qualitative research?

It can provide complex textual descriptions of how people experience a given research issue. It PROVIDES INFORMATION ABOUT THE HUMAN SIDE of an issue that is, the often contradictory behaviors, beliefs, opinions, emotions, and relationships of individuals.

What can we learn from qualitative research?

Qualitative methods are also EFFECTIVE IN IDENTIFYING INTANGIBLE FACTORS, such as social norms, socioeconomic status, gender roles, ethnicity, and religion, whose role in the research issue may not be readily apparent.

What can we learn from qualitative research?

When used along with quantitative methods, qualitative research can help us to INTERPRET AND BETTER UNDERSTAND THE COMPLEX REALITY of a given situation and the implications of quantitative data.

What forms do qualitative data take?

The types of data these three methods generate are
FIELD NOTES AUDIO (AND SOMETIMES VIDEO) RECORDINGS TRANSCRIPTS

Comparison of quantitative and qualitative research approaches

General framework
Quantitative Qualitative

Seek to confirm hypotheses about phenomena Instruments use more rigid style of eliciting and categorizing responses to questions
Use highly structured methods such as questionnaires, surveys, and structured observation

Seek to explore phenomena Instruments use more flexible, iterative style of eliciting and categorizing responses to questions
Use semi-structured methods such as in-depth interviews, focus groups, and participant observation

Comparison of quantitative and qualitative research approaches

Analytical objectives
Quantitative Qualitative

To quantify variation To predict causal relationships

To describe variation To describe and explain relationships

To describe characteristics of a population

To describe individual experiences or group norms

Comparison of quantitative and qualitative research approaches

Question format
Quantitative Qualitative

Closed-ended

Open-ended

Data format
Quantitative Numerical (obtained by assigning numerical values to responses) Qualitative Textual (obtained from audiotapes, videotapes, and field notes)

Comparison of quantitative and qualitative research approaches

Flexibility in study design
Quantitative Qualitative

Study design is stable from beginning to end

Some aspects of the study are flexible (for example, the addition, exclusion, or wording of particular interview questions)
Participant responses affect how and which questions researchers ask next Study design is iterative, that is, data collection and research questions are adjusted according to what is learned

Participant responses do not influence or determine how and which questions researchers ask next Study design is subject to statistical assumptions and conditions

Types of Qualitative Research

1. Phenomenology 2. Grounded Theory 3. Ethnography

1. Phenomenological Research
an inductive, descriptive approach developed from phenomenon

The focus is understanding the response of whole human being, not just specific parts of behaviors

1. Phenomenological Research

The aim : to describe an experience as it is lived by the person

describing a persons experience of pain as it is lived by that person

2. Grounded Theory Research

an inductive research technique useful in discovering problems which exist in a social scene the process persons use to handle them GTR emphasizes observation and the development of practice-based intuitive relationships between variables

2. Grounded Theory Research

The research process involves formulation, testing, and redevelopment of propositions until a theory evolves.

The theory developed is grounded or has its roots in the data from which it was derived

3. Ethnographic Research
investigating cultures through an in-depth study of the members of the culture.
attempts to tell the story of peoples daily lives while describing the culture they are a part of ER process is the systematic collection, description, and analysis of data to develop a theory of cultural behavior

3. Ethnographic Research
Using ER different cultures are described, compared and contrasted to add to the understanding of the impact of culture on human behavior and health