Phyllis Solomon, Mary M. Cavanaugh, and Jeffrey Draine
- Published in print:
- 2009
- Published Online:
- May 2009
- ISBN:
- 9780195333190
- eISBN:
- 9780199864317
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195333190.001.0001
- Subject:
- Social Work, Research and Evaluation
Randomized controlled trials (RCTs) have been considered a gold standard for health and social service research for generations of professionals. However, even as methods have developed to ...
More
Randomized controlled trials (RCTs) have been considered a gold standard for health and social service research for generations of professionals. However, even as methods have developed to accommodate a large number of professional perspectives and fields of intervention, few have adequately addressed the complex nature of RCTs conducted in community settings. In this book, Drs. Solomon, Cavanaugh, and Draine draw on their extensive experience conducting randomized controlled trials to compile a practical and accessible guide to RCTs in community-based practice settings. While providing a detailed, common-sense manual, the authors address numerous design and implementation challenges that are unique to practice settings, which are less-controlled environments than the typical clinic or consultation room. Such issues include: community and agency buy-in to support collaboration, addressing confounds to internal and external validity, and fidelity with complex interventions. These challenges are addressed through a mix of qualitative and quantitative methods that have supported RCT research in community-based settings. This pragmatic guide provides a thorough review of the basic ingredients for working through each step of the RCT process. It offers encouragement and support to enter this richly rewarding and challenging research area.Less
Randomized controlled trials (RCTs) have been considered a gold standard for health and social service research for generations of professionals. However, even as methods have developed to accommodate a large number of professional perspectives and fields of intervention, few have adequately addressed the complex nature of RCTs conducted in community settings. In this book, Drs. Solomon, Cavanaugh, and Draine draw on their extensive experience conducting randomized controlled trials to compile a practical and accessible guide to RCTs in community-based practice settings. While providing a detailed, common-sense manual, the authors address numerous design and implementation challenges that are unique to practice settings, which are less-controlled environments than the typical clinic or consultation room. Such issues include: community and agency buy-in to support collaboration, addressing confounds to internal and external validity, and fidelity with complex interventions. These challenges are addressed through a mix of qualitative and quantitative methods that have supported RCT research in community-based settings. This pragmatic guide provides a thorough review of the basic ingredients for working through each step of the RCT process. It offers encouragement and support to enter this richly rewarding and challenging research area.
Annie Britton
- Published in print:
- 2010
- Published Online:
- September 2010
- ISBN:
- 9780199569298
- eISBN:
- 9780191594427
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199569298.003.0004
- Subject:
- Public Health and Epidemiology, Public Health
An experimental study is the standard method for evaluating the effectiveness of a health or medical intervention. In such a study, a group of people will be exposed to an intervention and then ...
More
An experimental study is the standard method for evaluating the effectiveness of a health or medical intervention. In such a study, a group of people will be exposed to an intervention and then compared with another group (a control group) who have not been exposed, or with a group who had a different intervention. There are situations in which an experimental approach may not be feasible, ethical, or practical, but, when possible, well-designed controlled experiments provide reliable evidence on the effectiveness of interventions and inform the policies and practice of health promotion. This chapter discusses different experimental designs, explores their strengths and weaknesses, and determines how the most appropriate design might be chosen in light of the many unique features of health promotion interventions. It shows that well-conducted randomized controlled trials (RCTs) are a valid and important way of evaluating health promotion interventions.Less
An experimental study is the standard method for evaluating the effectiveness of a health or medical intervention. In such a study, a group of people will be exposed to an intervention and then compared with another group (a control group) who have not been exposed, or with a group who had a different intervention. There are situations in which an experimental approach may not be feasible, ethical, or practical, but, when possible, well-designed controlled experiments provide reliable evidence on the effectiveness of interventions and inform the policies and practice of health promotion. This chapter discusses different experimental designs, explores their strengths and weaknesses, and determines how the most appropriate design might be chosen in light of the many unique features of health promotion interventions. It shows that well-conducted randomized controlled trials (RCTs) are a valid and important way of evaluating health promotion interventions.
Mark F. Testa
- Published in print:
- 2010
- Published Online:
- May 2010
- ISBN:
- 9780195321302
- eISBN:
- 9780199777457
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195321302.003.0007
- Subject:
- Social Work, Children and Families, Communities and Organizations
This chapter lays out an evaluative framework for assessing the internal validity of promising interventions, which is sufficiently robust to withstand credible challenges to inferences about ...
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This chapter lays out an evaluative framework for assessing the internal validity of promising interventions, which is sufficiently robust to withstand credible challenges to inferences about causality, such as the average causal effect of an intervention on outcomes. A key claim is that randomized controlled experiments should be and can be implemented more routinely in child welfare than is currently the practice. Uncontrolled experimentation on vulnerable children and families by well-meaning child welfare agents is no more ethical than controlled experimentation that seeks to improve the validity of knowledge and the efficacy of practice and policy. This is especially important when empirical support is as tenuous as it currently is for many existing practices and policies in child welfare.Less
This chapter lays out an evaluative framework for assessing the internal validity of promising interventions, which is sufficiently robust to withstand credible challenges to inferences about causality, such as the average causal effect of an intervention on outcomes. A key claim is that randomized controlled experiments should be and can be implemented more routinely in child welfare than is currently the practice. Uncontrolled experimentation on vulnerable children and families by well-meaning child welfare agents is no more ethical than controlled experimentation that seeks to improve the validity of knowledge and the efficacy of practice and policy. This is especially important when empirical support is as tenuous as it currently is for many existing practices and policies in child welfare.
Phyllis Solomon, Mary M. Cavanaugh, and Jeffrey Draine
- Published in print:
- 2009
- Published Online:
- May 2009
- ISBN:
- 9780195333190
- eISBN:
- 9780199864317
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195333190.003.0001
- Subject:
- Social Work, Research and Evaluation
Randomized controlled trials (RCTs) are considered the gold standard of scientific evidence when determining the effectiveness of policy and practice interventions. In order to understand the basis ...
More
Randomized controlled trials (RCTs) are considered the gold standard of scientific evidence when determining the effectiveness of policy and practice interventions. In order to understand the basis for the importance and utility of RCTs to community-based psychosocial interventions, Chapter 1 outlines the following: 1) establishes a definition of RCTs within the context of real-world service delivery systems, 2) distinguishes RCTs from program evaluations and from quasi-experimental and pre-experimental designs, 3) discusses the significance of RCTs to evidence-based practice, and 4) provides an overview of the following chapters, which offer practical guidance in designing, planning, and conducting RCTs for social work practice, using case examples to illustrate the material presented. In addition, Chapter 1 defines the term “community-based psychosocial interventions” as reflecting the grounding of interventions in impacting the social context of the individual, as well as the inherent change within the individual.Less
Randomized controlled trials (RCTs) are considered the gold standard of scientific evidence when determining the effectiveness of policy and practice interventions. In order to understand the basis for the importance and utility of RCTs to community-based psychosocial interventions, Chapter 1 outlines the following: 1) establishes a definition of RCTs within the context of real-world service delivery systems, 2) distinguishes RCTs from program evaluations and from quasi-experimental and pre-experimental designs, 3) discusses the significance of RCTs to evidence-based practice, and 4) provides an overview of the following chapters, which offer practical guidance in designing, planning, and conducting RCTs for social work practice, using case examples to illustrate the material presented. In addition, Chapter 1 defines the term “community-based psychosocial interventions” as reflecting the grounding of interventions in impacting the social context of the individual, as well as the inherent change within the individual.
Ezra Susser, Sharon Schwartz, Alfredo Morabia, and Evelyn J. Bromet
- Published in print:
- 2006
- Published Online:
- September 2009
- ISBN:
- 9780195101812
- eISBN:
- 9780199864096
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195101812.003.06
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This chapter describes different risk factor study designs. Study designs can be viewed as techniques for organizing observations in ways that can reveal the causes of disease. The risk factor study ...
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This chapter describes different risk factor study designs. Study designs can be viewed as techniques for organizing observations in ways that can reveal the causes of disease. The risk factor study designs attempt to do this by mimicking the counterfactual, which is the true test of causal effects. When the mimicry is successful, studies isolate the effects of the exposure on the disease. In regard to this mimicry, the randomized controlled trial is the simplest and most direct, but practical for only a small number of exposures. The cohort study is much more widely applicable, but selection into exposure is not random. The case-control study is more complex and indirect but often the most useful. Although the specific techniques differ among designs, the underlying strategy is the same—the examination of fully comparable groups of exposed and unexposed individuals to isolate the effects of specific risk factors. The chapter illustrates how each study was used to investigate the causal effect of low prenatal folate intake on neural tube defects (NTDs).Less
This chapter describes different risk factor study designs. Study designs can be viewed as techniques for organizing observations in ways that can reveal the causes of disease. The risk factor study designs attempt to do this by mimicking the counterfactual, which is the true test of causal effects. When the mimicry is successful, studies isolate the effects of the exposure on the disease. In regard to this mimicry, the randomized controlled trial is the simplest and most direct, but practical for only a small number of exposures. The cohort study is much more widely applicable, but selection into exposure is not random. The case-control study is more complex and indirect but often the most useful. Although the specific techniques differ among designs, the underlying strategy is the same—the examination of fully comparable groups of exposed and unexposed individuals to isolate the effects of specific risk factors. The chapter illustrates how each study was used to investigate the causal effect of low prenatal folate intake on neural tube defects (NTDs).
Sheila Bird
- Published in print:
- 2003
- Published Online:
- September 2009
- ISBN:
- 9780198508496
- eISBN:
- 9780191723797
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198508496.003.0006
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This chapter considers the strengths and limitations of a range of evaluation study designs, focusing on the consumer principle of randomization. Although much of the chapter is devoted to randomized ...
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This chapter considers the strengths and limitations of a range of evaluation study designs, focusing on the consumer principle of randomization. Although much of the chapter is devoted to randomized controlled trials (RCTs), non-randomized studies such as disease registries and cohort studies are included because of their importance in the evaluation of cost-effectiveness. The chapter also considers issues of informed consent that are relevant to choice of experimental design, and the need for database linkage to overcome informative loss to follow-up that might otherwise undermine randomized allocation.Less
This chapter considers the strengths and limitations of a range of evaluation study designs, focusing on the consumer principle of randomization. Although much of the chapter is devoted to randomized controlled trials (RCTs), non-randomized studies such as disease registries and cohort studies are included because of their importance in the evaluation of cost-effectiveness. The chapter also considers issues of informed consent that are relevant to choice of experimental design, and the need for database linkage to overcome informative loss to follow-up that might otherwise undermine randomized allocation.
John Wright
- Published in print:
- 2010
- Published Online:
- May 2010
- ISBN:
- 9780199238934
- eISBN:
- 9780191716621
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199238934.003.03
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This chapter discusses the following topics: What is epidemiology? How do we measure disease? using rates in measuring disease; describing disease in terms of time, place, and person; defining cases ...
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This chapter discusses the following topics: What is epidemiology? How do we measure disease? using rates in measuring disease; describing disease in terms of time, place, and person; defining cases and populations; and undertaking health surveys. It also discusses randomized controlled trials and systematic reviews.Less
This chapter discusses the following topics: What is epidemiology? How do we measure disease? using rates in measuring disease; describing disease in terms of time, place, and person; defining cases and populations; and undertaking health surveys. It also discusses randomized controlled trials and systematic reviews.
Miriam Solomon
- Published in print:
- 2015
- Published Online:
- June 2015
- ISBN:
- 9780198732617
- eISBN:
- 9780191796838
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198732617.003.0006
- Subject:
- Philosophy, Metaphysics/Epistemology, Philosophy of Science
Evidence-based medicine is designed to minimize bias. Several philosophers have argued that the methods of evidence-based medicine do not eliminate the possibility of bias and error. This chapter ...
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Evidence-based medicine is designed to minimize bias. Several philosophers have argued that the methods of evidence-based medicine do not eliminate the possibility of bias and error. This chapter considers these arguments, and finds them less compelling than the empirical findings of John Ioannidis and others that randomized controlled trials and even meta-analyses are less replicable than expected. Moreover, observational trials are much closer than expected to randomized controlled trials in external validity. The quality of clinical trials is multidimensional and not appropriately captured by the usual linear hierarchy of evidence. Possible solutions for various sources of bias and error are also considered.Less
Evidence-based medicine is designed to minimize bias. Several philosophers have argued that the methods of evidence-based medicine do not eliminate the possibility of bias and error. This chapter considers these arguments, and finds them less compelling than the empirical findings of John Ioannidis and others that randomized controlled trials and even meta-analyses are less replicable than expected. Moreover, observational trials are much closer than expected to randomized controlled trials in external validity. The quality of clinical trials is multidimensional and not appropriately captured by the usual linear hierarchy of evidence. Possible solutions for various sources of bias and error are also considered.
Annie Britton and Margaret Thorogood
- Published in print:
- 2004
- Published Online:
- September 2009
- ISBN:
- 9780198528807
- eISBN:
- 9780191723964
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198528807.003.0005
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
An experimental study is the standard method for evaluating clinical effectiveness. In such a study, a group of people exposed to an intervention is compared with another group that has not been ...
More
An experimental study is the standard method for evaluating clinical effectiveness. In such a study, a group of people exposed to an intervention is compared with another group that has not been exposed. There are a range of study designs with various advantages and disadvantages. This chapter discusses these different designs and how the most appropriate design must be chosen. It considers some of the strengths and weaknesses of randomized controlled trials and describes some other forms of experimental design used in health promotion.Less
An experimental study is the standard method for evaluating clinical effectiveness. In such a study, a group of people exposed to an intervention is compared with another group that has not been exposed. There are a range of study designs with various advantages and disadvantages. This chapter discusses these different designs and how the most appropriate design must be chosen. It considers some of the strengths and weaknesses of randomized controlled trials and describes some other forms of experimental design used in health promotion.
Henry McQuay
- Published in print:
- 2010
- Published Online:
- January 2011
- ISBN:
- 9780199558612
- eISBN:
- 9780191595011
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199558612.003.0009
- Subject:
- Public Health and Epidemiology, Public Health
Evidence-based medicine (EBM) is defined as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. This chapter discusses ...
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Evidence-based medicine (EBM) is defined as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. This chapter discusses randomized controlled trials and systematic reviews, which are the most reliable sources of evidence.Less
Evidence-based medicine (EBM) is defined as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. This chapter discusses randomized controlled trials and systematic reviews, which are the most reliable sources of evidence.
Colleen Derkatch
- Published in print:
- 2016
- Published Online:
- September 2016
- ISBN:
- 9780226345840
- eISBN:
- 9780226345987
- Item type:
- chapter
- Publisher:
- University of Chicago Press
- DOI:
- 10.7208/chicago/9780226345987.003.0004
- Subject:
- History, History of Science, Technology, and Medicine
This chapter focuses on scientific method as the key rhetorical topos, or topic, within evidence-based medicine that furnishes lines of argument that researchers adopt to align complementary and ...
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This chapter focuses on scientific method as the key rhetorical topos, or topic, within evidence-based medicine that furnishes lines of argument that researchers adopt to align complementary and alternative medicine (CAM) with scientific boundaries. At the core of debates about CAM is an epistemological debate about how research on CAM ought to be conducted, interpreted, and incorporated into practice because biomedicine’s “gold standard” methodology, the randomized controlled trial (RCT), does not easily accommodate interventions such as acupuncture. The chapter examines how CAM practices fit awkwardly within the RCT format and, turning to studies of experimental articles in rhetoric of science, rhetoric of medicine, and genre theory, investigates how the experimental genre is mobilized in the specific case of biomedical CAM research. It then isolates the concept of efficacy—whether or not a health intervention “works”—as a central organizing principle of biomedical research on CAM. The chapter shows that efficacy can be invoked strategically to draw epistemic and professional boundaries. As this chapter argues, the problem of method in biomedical CAM research is largely a problem of persuasion: the ways that researchers design their studies and report their findings determine which health interventions belong in biomedicine and which do not.Less
This chapter focuses on scientific method as the key rhetorical topos, or topic, within evidence-based medicine that furnishes lines of argument that researchers adopt to align complementary and alternative medicine (CAM) with scientific boundaries. At the core of debates about CAM is an epistemological debate about how research on CAM ought to be conducted, interpreted, and incorporated into practice because biomedicine’s “gold standard” methodology, the randomized controlled trial (RCT), does not easily accommodate interventions such as acupuncture. The chapter examines how CAM practices fit awkwardly within the RCT format and, turning to studies of experimental articles in rhetoric of science, rhetoric of medicine, and genre theory, investigates how the experimental genre is mobilized in the specific case of biomedical CAM research. It then isolates the concept of efficacy—whether or not a health intervention “works”—as a central organizing principle of biomedical research on CAM. The chapter shows that efficacy can be invoked strategically to draw epistemic and professional boundaries. As this chapter argues, the problem of method in biomedical CAM research is largely a problem of persuasion: the ways that researchers design their studies and report their findings determine which health interventions belong in biomedicine and which do not.
Michael B. Bracken
- Published in print:
- 2013
- Published Online:
- October 2013
- ISBN:
- 9780300188844
- eISBN:
- 9780300189551
- Item type:
- chapter
- Publisher:
- Yale University Press
- DOI:
- 10.12987/yale/9780300188844.003.0004
- Subject:
- History, Environmental History
This chapter investigates the methods used to demonstrate causality via a consideration of the type of study design that most readily lends itself to doing so. In the case of drug therapy or some ...
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This chapter investigates the methods used to demonstrate causality via a consideration of the type of study design that most readily lends itself to doing so. In the case of drug therapy or some other type of medical act, determining whether it improves an illness or causes harm requires a randomized controlled trial. This study design is often thought of as the gold standard for medical and social research, and it is discussed here as the touchstone against which other research methodologies will be compared. Randomization is a simple enough concept, but it is not always easy to execute in practice. It allows the play of chance to determine whether someone is treated or “exposed” with one type of therapy versus another form of treatment or with no treatment at all.Less
This chapter investigates the methods used to demonstrate causality via a consideration of the type of study design that most readily lends itself to doing so. In the case of drug therapy or some other type of medical act, determining whether it improves an illness or causes harm requires a randomized controlled trial. This study design is often thought of as the gold standard for medical and social research, and it is discussed here as the touchstone against which other research methodologies will be compared. Randomization is a simple enough concept, but it is not always easy to execute in practice. It allows the play of chance to determine whether someone is treated or “exposed” with one type of therapy versus another form of treatment or with no treatment at all.
John Poertner
- Published in print:
- 2010
- Published Online:
- May 2010
- ISBN:
- 9780195321302
- eISBN:
- 9780199777457
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195321302.003.0006
- Subject:
- Social Work, Children and Families, Communities and Organizations
The Adoption and Safe Families Act of 1997 (ASFA) specified the accountability concerns for public child welfare and codified the outcomes for children served in these systems as safety, permanence, ...
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The Adoption and Safe Families Act of 1997 (ASFA) specified the accountability concerns for public child welfare and codified the outcomes for children served in these systems as safety, permanence, and wellbeing. The drive to define, measure, report, and manage these results has dominated the field for many years, even prior to the passage of ASFA. However, some people suggest that the outcome movement has so skewed attention to results that the practices which produce them have been lost. This chapter outlines an approach toward assessing the external validity of child welfare practices through research reviews of empirically-supported practices and policies across variations in populations, settings, interventions, and outcomes.Less
The Adoption and Safe Families Act of 1997 (ASFA) specified the accountability concerns for public child welfare and codified the outcomes for children served in these systems as safety, permanence, and wellbeing. The drive to define, measure, report, and manage these results has dominated the field for many years, even prior to the passage of ASFA. However, some people suggest that the outcome movement has so skewed attention to results that the practices which produce them have been lost. This chapter outlines an approach toward assessing the external validity of child welfare practices through research reviews of empirically-supported practices and policies across variations in populations, settings, interventions, and outcomes.
Angela E. Raffle and J. A. Muir Gray
- Published in print:
- 2007
- Published Online:
- September 2009
- ISBN:
- 9780199214495
- eISBN:
- 9780191723742
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199214495.003.0004
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This chapter gives an understanding of evidence about screening at the level needed by a public health practitioner who has to interpret evidence for setting screening policy, or for ensuring high ...
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This chapter gives an understanding of evidence about screening at the level needed by a public health practitioner who has to interpret evidence for setting screening policy, or for ensuring high quality service delivery. It takes a very clear and practical approach, illustrating everything with real-life case histories and examples, ranging from infant neuroblastoma to ovarian screening. The issues are simplified into a logical structure. First are the Three Main Biases (healthy screenee effect, length time effect, lead time effect). Then there are the Three Main Evaluation Methods (randomised controlled trials, time trend analyses, case control studies). After that there are the Two Additional Sources of Information (pilot or demonstration projects, modelling), and Test Performance (sensitivity and specificity, positive and negative predictive value, receiver operator characteristic curves). Finally, the chapter describes Summarising Information on all Outcomes (the numbers in the flow diagram, and decision aids).Less
This chapter gives an understanding of evidence about screening at the level needed by a public health practitioner who has to interpret evidence for setting screening policy, or for ensuring high quality service delivery. It takes a very clear and practical approach, illustrating everything with real-life case histories and examples, ranging from infant neuroblastoma to ovarian screening. The issues are simplified into a logical structure. First are the Three Main Biases (healthy screenee effect, length time effect, lead time effect). Then there are the Three Main Evaluation Methods (randomised controlled trials, time trend analyses, case control studies). After that there are the Two Additional Sources of Information (pilot or demonstration projects, modelling), and Test Performance (sensitivity and specificity, positive and negative predictive value, receiver operator characteristic curves). Finally, the chapter describes Summarising Information on all Outcomes (the numbers in the flow diagram, and decision aids).
Lawrence A. Palinkas
- Published in print:
- 2011
- Published Online:
- January 2012
- ISBN:
- 9780195398489
- eISBN:
- 9780199928583
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195398489.003.0004
- Subject:
- Social Work, Research and Evaluation
This chapter reviews the latest methods in research on the process and outcomes of research translation in social work practice. First, we examine some of the principles and practices of ...
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This chapter reviews the latest methods in research on the process and outcomes of research translation in social work practice. First, we examine some of the principles and practices of translational research. A case study of an ongoing randomized controlled trial of an EBP implementation strategy in child welfare offers an illustration of how to conduct research on process and outcomes. We then examine some of the challenges involved in conducting translational research, including the identification of specific concepts and measurement procedures for each form of translation, consideration of the dynamic nature of the EBP/translation process, constraints imposed on sample size by the organizational context of translation, engagement of all relevant stakeholders in the conduct of research, and the limitations inherent in randomized controlled trial designs. We conclude with a discussion of infrastructure requirements for conducting translational research, with particular attention to staffing, research–community partnerships, and participant compensation.Less
This chapter reviews the latest methods in research on the process and outcomes of research translation in social work practice. First, we examine some of the principles and practices of translational research. A case study of an ongoing randomized controlled trial of an EBP implementation strategy in child welfare offers an illustration of how to conduct research on process and outcomes. We then examine some of the challenges involved in conducting translational research, including the identification of specific concepts and measurement procedures for each form of translation, consideration of the dynamic nature of the EBP/translation process, constraints imposed on sample size by the organizational context of translation, engagement of all relevant stakeholders in the conduct of research, and the limitations inherent in randomized controlled trial designs. We conclude with a discussion of infrastructure requirements for conducting translational research, with particular attention to staffing, research–community partnerships, and participant compensation.
Janet Richardson and Karen Pilkington
- Published in print:
- 2007
- Published Online:
- November 2011
- ISBN:
- 9780199297559
- eISBN:
- 9780191730023
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199297559.003.0002
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
The nature and complexities of complementary therapies and their underpinning philosophical approaches present a challenge to the research community. Some complementary therapies have the potential ...
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The nature and complexities of complementary therapies and their underpinning philosophical approaches present a challenge to the research community. Some complementary therapies have the potential to provide supportive (such as quality of life) benefits and symptom relief in patients with cancer. Evidence for their effectiveness from randomised controlled trials is limited due to the lack of trials of high methodological quality. Nonetheless, in an increasingly evidence-based treatment culture, healthcare professionals and people with cancer will need to have access to the best-available evidence on the effectiveness of complementary therapies. This chapter presents a summary of the current research findings, considers the methodological challenges and safety issues, and provides resources for further details. Complementary therapies, such as acupuncture, homeopathy, massage, aromatherapy, and yoga, have the potential to provide some relief for the symptoms of cancer and the side effects of treatments. These symptoms range from breathlessness to hot flushes, dry mouth problems due to chemotherapy, nausea and vomiting induced by chemotherapy, and pain. Plant-based treatments for cancer are also discussed.Less
The nature and complexities of complementary therapies and their underpinning philosophical approaches present a challenge to the research community. Some complementary therapies have the potential to provide supportive (such as quality of life) benefits and symptom relief in patients with cancer. Evidence for their effectiveness from randomised controlled trials is limited due to the lack of trials of high methodological quality. Nonetheless, in an increasingly evidence-based treatment culture, healthcare professionals and people with cancer will need to have access to the best-available evidence on the effectiveness of complementary therapies. This chapter presents a summary of the current research findings, considers the methodological challenges and safety issues, and provides resources for further details. Complementary therapies, such as acupuncture, homeopathy, massage, aromatherapy, and yoga, have the potential to provide some relief for the symptoms of cancer and the side effects of treatments. These symptoms range from breathlessness to hot flushes, dry mouth problems due to chemotherapy, nausea and vomiting induced by chemotherapy, and pain. Plant-based treatments for cancer are also discussed.
Huw Davies, Sandra Nutley, and Nick Tilley
- Published in print:
- 2000
- Published Online:
- March 2012
- ISBN:
- 9781861341914
- eISBN:
- 9781447304265
- Item type:
- chapter
- Publisher:
- Policy Press
- DOI:
- 10.1332/policypress/9781861341914.003.0012
- Subject:
- Sociology, Social Research and Statistics
Interventions are delivered with the hope of achieving some outcome. Whether such interventions ‘work’ in terms of achieving the desired outcomes is paramount. In the view of many, experimentation, ...
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Interventions are delivered with the hope of achieving some outcome. Whether such interventions ‘work’ in terms of achieving the desired outcomes is paramount. In the view of many, experimentation, in the form of the randomised controlled trial, has become the ‘gold standard’ in producing evidence of such effects. Within many parts of healthcare, experimentation has become obligatory, and there are evangelical advocates for its adoption in other sectors. However, this chapter notes growing unease with experimentation in certain quarters for a number of reasons, fundamentally because it rarely offers useful insights into why a particular intervention performs better than another. When the interest is in what works in what context, such information may be crucial. The chapter explores the use of theory-driven evaluation as one possible way forward.Less
Interventions are delivered with the hope of achieving some outcome. Whether such interventions ‘work’ in terms of achieving the desired outcomes is paramount. In the view of many, experimentation, in the form of the randomised controlled trial, has become the ‘gold standard’ in producing evidence of such effects. Within many parts of healthcare, experimentation has become obligatory, and there are evangelical advocates for its adoption in other sectors. However, this chapter notes growing unease with experimentation in certain quarters for a number of reasons, fundamentally because it rarely offers useful insights into why a particular intervention performs better than another. When the interest is in what works in what context, such information may be crucial. The chapter explores the use of theory-driven evaluation as one possible way forward.
R. Paul Thompson
- Published in print:
- 2011
- Published Online:
- September 2011
- ISBN:
- 9780199574131
- eISBN:
- 9780191728921
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199574131.003.0002
- Subject:
- Mathematics, Logic / Computer Science / Mathematical Philosophy
Randomized controlled trials (RCTs) are pervasive in clinical medical research, which stands in stark contrast to other sciences such as physics, chemistry and biology. Most clinical researchers that ...
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Randomized controlled trials (RCTs) are pervasive in clinical medical research, which stands in stark contrast to other sciences such as physics, chemistry and biology. Most clinical researchers that use RCTs regard them as uncovering causal connections. R. A. Fisher best articulated the rationale for this position in 1935. According to Fisher, if randomization, blocking and replication demonstrated a connection between an intervention and an outcome, that connection is causal. This chapter argues that RCTs in clinical medicine do not reveal causal connections. Causal claims in clinical medicine, as in the rest of science, are justified by reference to a robust theory, not RCTs. Part of the argument rests on crucial differences between Fisher's use of RCTs in agriculture and the current use of RCTs in clinical medicine. Two key differences are: the different role of randomization and the legitimacy of assuming homogeneity of the intervention and control entities. A more significant part rests on the integrative power of robust theories; causal attributions are justified by demonstrating that they are, or can be, embedded in a large well-confirm framework. RCTs, by contrast, at best provide isolated input-output connections. A secondary thesis of the paper is that robust theories also allow causal claims to be well-confirmed.Less
Randomized controlled trials (RCTs) are pervasive in clinical medical research, which stands in stark contrast to other sciences such as physics, chemistry and biology. Most clinical researchers that use RCTs regard them as uncovering causal connections. R. A. Fisher best articulated the rationale for this position in 1935. According to Fisher, if randomization, blocking and replication demonstrated a connection between an intervention and an outcome, that connection is causal. This chapter argues that RCTs in clinical medicine do not reveal causal connections. Causal claims in clinical medicine, as in the rest of science, are justified by reference to a robust theory, not RCTs. Part of the argument rests on crucial differences between Fisher's use of RCTs in agriculture and the current use of RCTs in clinical medicine. Two key differences are: the different role of randomization and the legitimacy of assuming homogeneity of the intervention and control entities. A more significant part rests on the integrative power of robust theories; causal attributions are justified by demonstrating that they are, or can be, embedded in a large well-confirm framework. RCTs, by contrast, at best provide isolated input-output connections. A secondary thesis of the paper is that robust theories also allow causal claims to be well-confirmed.
J. A. Muir Gray
- Published in print:
- 2011
- Published Online:
- May 2016
- ISBN:
- 9780262016032
- eISBN:
- 9780262298957
- Item type:
- chapter
- Publisher:
- The MIT Press
- DOI:
- 10.7551/mitpress/9780262016032.003.0007
- Subject:
- Psychology, Health Psychology
The quality of medical research depends on the use of structured protocols. Problems associated with poor quality research reports range from poor design to improper management or irrelevant ...
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The quality of medical research depends on the use of structured protocols. Problems associated with poor quality research reports range from poor design to improper management or irrelevant research. Structured protocols have been shown to improve reporting, yet implementation and adherence remain major issues for those who fund research as well as for those who publish the results. In addition, the peer-review process used in research selection and publication contains flaws that must be addressed. Priority needs to be given to systematic reviews of randomized controlled trials, as these yield higher quality, stronger evidence than the report of any single controlled trial.Less
The quality of medical research depends on the use of structured protocols. Problems associated with poor quality research reports range from poor design to improper management or irrelevant research. Structured protocols have been shown to improve reporting, yet implementation and adherence remain major issues for those who fund research as well as for those who publish the results. In addition, the peer-review process used in research selection and publication contains flaws that must be addressed. Priority needs to be given to systematic reviews of randomized controlled trials, as these yield higher quality, stronger evidence than the report of any single controlled trial.
Tracey J. Stone
- Published in print:
- 2004
- Published Online:
- March 2012
- ISBN:
- 9781861345141
- eISBN:
- 9781447303220
- Item type:
- chapter
- Publisher:
- Policy Press
- DOI:
- 10.1332/policypress/9781861345141.003.0003
- Subject:
- Sociology, Social Research and Statistics
This chapter describes the decision making of a purposively sampled group of oncology patients about taking part in a randomised controlled trial (RCT). The data presented in this chapter was ...
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This chapter describes the decision making of a purposively sampled group of oncology patients about taking part in a randomised controlled trial (RCT). The data presented in this chapter was gathered for a NHS-sponsored PhD project, with the aim of giving feed back to local clinical researchers and Research Ethics Committees in order to improve the process of future patients. This chapter, therefore, is structured around the idea of choice, of what participants understood of their choice to be, and to what extent they felt free to choose. This has associated implications for the ethical requirement of voluntariness in informed consent. Features of the process that they felt made the decisions more or less difficult is covered in this chapter including the variances in attitudes to the risks contingent in research involvement and the way in which information about risk was used. The roles of self-interest and altruism in deciding whether to agree to take part in research are also discussed in this chapter.Less
This chapter describes the decision making of a purposively sampled group of oncology patients about taking part in a randomised controlled trial (RCT). The data presented in this chapter was gathered for a NHS-sponsored PhD project, with the aim of giving feed back to local clinical researchers and Research Ethics Committees in order to improve the process of future patients. This chapter, therefore, is structured around the idea of choice, of what participants understood of their choice to be, and to what extent they felt free to choose. This has associated implications for the ethical requirement of voluntariness in informed consent. Features of the process that they felt made the decisions more or less difficult is covered in this chapter including the variances in attitudes to the risks contingent in research involvement and the way in which information about risk was used. The roles of self-interest and altruism in deciding whether to agree to take part in research are also discussed in this chapter.
