Question

There are several different types of studies that can help make data from research credible and therefore useful to healthcare managers and leaders. Credible data is vital to making safe decisions. From thorough research of at least three credible sources, please discuss the following tools used in research:

Case-control studies

Cohort studies, retrospective and prospective

Randomized clinical trials

Include the following key concepts in your discussion of each study:

Data that can be collected and used by healthcare leaders and managers

Inherent biases

Cost effectiveness

Level of reliability using the hierarchy of evidence rating method

An example of the study

Answer 1

RESEARCH--systematic investigation into and study of materials and sources in order to establish facts and reach new conclusions.

INHERENT BIAS:Effect of underlying factors or assumptions that skew viewpoints of a subject under discussion.

COST EFFECTIVENESS:Research is the comparative  analysis of two or more alternative interventions in terms of their health and economic consequences.

they are expressed in cost effective ratio--the ratio of difference in cost between a pair of medical intervention to difference in corresponding health effects.

RELIABILITY:It is the degree to which research method produces stable and consistent results.

CASE CONTROL STUDY

IT IS A STUDY THAT IDENTIFIES FACTORS THAT MAY CONTRIBUTE TO A MEDICAL CONDITION BY COMPARING SUBJECTS WHO HAVE THAT CONDITION OR DISEASE (THE CASE) WITH PATIENTS WHO DO NOT HAVE THE CONDITION OR DISEASE BUT ARE OTHERWISE SIMILAR (THE CONTROLS)

EXAMPLE: in a study trying to show people who smoke are more likely to be diagonal and have lung cancer---the cases would be the persons with lung cancer and controls would be without lung cancer (not necessarily healthy)--and some of each group would be smokers

INHERENT BIAS: selection of comparable control group the source of controls is dependent on source of cases. in order to minimize bias controls should be selected to be representative sample of population which produced the cases.

COST EFFECTIVENESS:Less costly and less time consuming.They are advantageous when exposure data is expensive or hard to obtain.

RELIABILITY:They are comparatively quick,inexpensive and easy they are particularly applicable for investing outbreaks and studying rare diseases or outcomes

COHORT STUDIES

IT IS A TYPE OF MEDICAL RESEARCH USED TO INVESTIGATE THE CAUSE OF DISEASE AND TO ESTABLISH LINKS BETWEEN RISK FACTORS AND HEALTH OUTCOMES

COHORT IS A GROUP OF PEOPLE

INDICATORS:When there is strong association between cause and effect established by observational studies

-- exposure is rare but incidence of disease among exposed is high

-- when people's attrition can be minimized

EXAMPLE: Exposure to any risk factors (like smoking) associates with outcome (lung cancer)

there are two types of cohort studies 1.RETROSPECTIVE STUDIES

2.PROSPECTIVE STUDIES

RETROSPECTIVE: Looking back in time by using data such as medical records or claims data base

this type of studies restricts the investigators ability to reduce confounding and bias because collected information is restricted to data that already exists

advantage: these are very cheap and fast because data is already collected

PROSPECTIVE STUDY: Longitudinal cohort study that follows overtime a group of similar individuals who differ with respect to certain factors under study to determine how these factors affect rates of certain outcome

INHERENT BIAS:Selection has to be related to both exposure and outcome.bias can occur if selection or choice of exposed or unexposed subjects in a retrospective cohort study is somehow related to the outcome of study

COST EFFECTIVENESS: these studies are very cost effective...they are very fast and need less cost to perform

RELIABILITY: Prospective studies are considered to yield most reliable results

RANDOMIZED CLINICAL TRIALS (RCT)

It is a type of scientific (often medical) experiment that aims to reduce certain sources of bias when testing the effectiveness

this is accomplished by randomly allocating subjects to two or more groups treating them differently and then comparing them with respect to a measured response.

One group -- EXPERIMENTAL GROUP which has an intervention being assessed

and the other group CONTROL GROUP-- has an alternative condition or no intervention .

these groups are followed under condition of trial design to see hoe effective the experimental intervention was.

treatment efficacy is assessed in comparison to the control group.

there may be more than one treatment group or more than one control group

INHERENT BIAS: outcome choice bias:sometimes evaluates outcomes that are easy to measure,rather than outcomes that are relevant(measurement bias)

COST EFFECTIVENESS--These kind of studies are costly and time taking

RELIABILITY:Systematic investigation in to and study of materials and sources in order to establish facts and reach new conclusion is needed.these kind of studies are the most reliable once because experiments have been conducted ...