The two major study designs–cohort and case-control–used in health care research.
This week you will learn how research is used to enhance public health. You will learn how to critically read and analyze research studies to determine whether the methods used in the research are appropriate for program planning and development for your community. You will also learn how to obtain funding for research work and how to design and conduct your own research. As a health professional, analyzing research will be a required skill, as public health is rapidly moving towards the use of evidence-based prevention and intervention programs. Most research articles are obtained from research that has been conducted using scientific principles and published in peer-reviewed journals. You must be able to critically analyze and read research studies and, more importantly, determine if the findings are appropriate for the population you are serving. For example, a prevention and intervention program developed from a study for substance abusers, where the study subjects were college-aged students, may not work for a population consisting of adults with no more than a high school education and who are low income.
Your Learning Objectives for the Week:
Read epidemiological studies and draw conclusions.
Conduct preliminary research in current issues in public health
Reading Causes in Statistics
As you pursue a profession in health care, you may encounter many opportunities to read and assess information from research studies. When reading such studies, strive to understand the scientific contributions the authors are making. Components of a Research Paper: Introduction: This section gives an overview of the paper, identifying key concepts, hypothesis and goals, and the type of study conducted (i.e. case-control, cohort, etc.). Materials and Methods: This gives you a detailed description of how the study was carried out. You will learn where the study was conducted, data sources, type of data used (primary or secondary), methods and measures are used to collect the data, and inclusion and exclusion criteria. Results: This section states the results in the form of tables and graphs. Results usually include demographics, descriptive (means, etc.), and outcome measures. Discussion: In this section, the results are analyzed and the outcome, limitations, and implications of the results are explained. You will also find information on how the results compare or contrast with other related researches in the field of public health care. Conclusion: Here the hypothesis is restated and the results are reiterated.
Funding for Research
Research is costly and securing funding for research is not easy. The five main sources of research funding are the government (e.g., National Institutes of Health [NIH]), private nonprofit institutions (e.g., Pew Charitable Foundation), private profit-making organizations (e.g., Merck), intramural resources (e.g., universities), and international organizations.
The NIH is the main governmental organization that provides funding for research in the United States. Private foundations generally restrict funding to specific areas of interest, and they often support studies of merit that the NIH would not fund. Corporations support studies of how well a drug or equipment works. Usually the drug or equipment manufacturer provides the funds. The main disadvantage is that the research questions are designed to meet corporate goals; therefore, the objectivity of these studies is often questionable. Intramural resources are funds provided by the investigator’s own university or institution. Intramural funds are usually limited to small amounts but are available in a shorter time and to a higher proportion of applicants than grants from other organizations. There are several international organizations that fund research around the world including the World Health Organization, the Pan American Health Organization, Organization of American States, and the World Bank.
In this lecture, we learned about securing funding for research and the sources from which funding comes. The funding landscape often shifts with changing social and political tides. Whether or not this is fair is a point of contention among many researchers. For more information on research funding, please review the following:
Fishing for complementaries: Research grants and research productivity
Corporate sponsorship of global health research
Health Research and Methods
Several study designs are available to investigate the relationship between health and risk factors. Study design choice design depends on the availability of information, funds, risks involved, and the outcome of interest. Studies fall into two major categories: observational and experimental. Observational studies involve observing, measuring, recording and taking no action that would affect the outcome. With experimental studies, researchers exercise control over the participants and can manipulate variables of interest. A sample must have some people who were exposed to the risk factor of interest and others who were not exposed. In a case-control or retrospective study, some of the samples selected have the disease (cases) and some don’t (controls). Subjects are studied retrospectively to determine if they were exposed to the risk factor under investigation. A cross-sectional study selects a random or representative sample and tests the subjects to separate those who have the disease. Its sample is a cross-section of the population. A cohort study uses a sample of healthy subjects. Some have been exposed to the risk factor and others have not. This cohort is observed over a period of time to measure how many develop the disease.
In this lecture, we learned about observational and experimental studies, all of which provide critical data to researchers. For more information on research studies, please review the following:
Observational research methods
Model-based estimation of the attributable fraction for cross-sectional, case-control, and cohort studies using the R package AF
Textbook:
Title: Introduction to Public Health, (5th ed.)
Author: Mary-Jane Schneider
Ed/Year: 4th/2014
Publisher: Jones and Bartlett
Using the South University Online Library or the Internet, research the two major study designs–cohort and case-control–used in health care research. Find a research article on any topic in health care. Based on your research, please address the following:
Although cohort studies are very powerful, case-control studies tend to be more popular. Do you agree with the statement? Why or why not?
How does the cohort study design differ from the case-control study design?
What is essentially the main use or purpose of the cohort study design and case-control study design?
When it is best to use the cohort study design and when is it best to use the case-control study design?
What characteristics of cohort study design make it important in health care research?
Cohort studies can be retrospective or prospective. What makes a cohort study retrospective or prospective?
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