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PubMed1987

A comparison of three allied health manpower projection methodologies.

Three manpower projection methodologies most often employed in the allied health sciences were compared: population ratio, occupational matrix, and regression analysis. Comparisons were made among the methodologies themselves, their strengths, and their weaknesses. These methodologies were then applied to the largest allied health discipline - clinical laboratory sciences - using Kentucky statewide data. The resultant projections were then compared with actual data (F.J. Morris, PhD, unpublished data, 1985). The most appropriate methodology to be used by the administrator should be determined by his/her specific needs and goals in relation to the specific strengths and weaknesses of the individual methodology.

Allied Health Personnel↗

PubMed1984

Methodologies for predicting the expected combined stochastic radiobiological effects of different ionizing radiations and some applications.

A methodology for predicting the expected combined stochastic radiobiological effects of sequential exposure to different ionizing radiations is used to arrive at a methodology for predicting the radiobiological effects of simultaneous exposure. Both methodologies require developing additive-damage dose-effect models. Additive-damage dose-effect models are derived assuming (a) each radiation comprised by the combined exposure produces initial damage called critical damage that could lead to the radiobiological effect of interest; (b) doses of different radiations that lead to the same level of radiobiological effect (or risk) can be viewed as producing the same amount of critical damage and being indistinguishable as far as the effects of subsequently administered radiation. Derived dose-effect functions that describe the risk per individual, conditional on radiation dose, are called risk functions. The methodologies allow the use of known radiation-specific risk functions to derive risk functions for combined effects of different radiations. The risk functions for combined exposure to different radiations are called global risk functions. For sequential exposures to different ionizing radiations, the global risk functions derived depend on how individual radiation doses are ordered. Global risk functions can also differ for sequential and simultaneous exposure. The methodologies are used to account for some previously unexplained radiobiological effects of combined exposure to high and low linear-energy-transfer radiations.

Alpha Particles↗

PubMed1994

Quantitative comparison of pre-explosions and subheadings with methodologic search terms in MEDLINE.

OBJECTIVE: To compare the retrieval characteristics of subheadings with methodologic textwords and MeSH terms in MEDLINE for identifying sound clinical studies on the etiology, prognosis, diagnosis, prevention and treatment of disorders in general adult medicine. DESIGN: Analytic survey of the information retrieval properties of methodologic textwords, single methodologic MeSH terms, pre-explosions and subheadings selected to detect studies meeting basic methodologic criteria for direct clinical use in general adult medicine. MEASURES: The sensitivity, specificity, and precision of search terms were determined by comparing the citations retrieved by the search strategies in MEDLINE with that of a manual review (the gold standard) of all articles in 10 internal and general medicine journals for 1986 and 1991. RESULTS: For treatment and diagnosis in 1991, and treatment, diagnosis, and etiology in 1986, pre-explosions yielded the highest sensitivity, with typical absolute increases exceeding 15%. For etiology and prognosis in 1991, and prognosis in 1986, textwords or MeSH terms yielded the highest sensitivity. In all cases the increase in sensitivity was coupled with a loss in specificity and precision. CONCLUSIONS: Compared with searching with single methodologic textwords and subject headings, the detection of sound clinical studies on the diagnosis and treatment of disorders in general adult medicine was consistently enhanced by searching with pre-explosions, but at a price of decreased specificity and precision.

Abstracting and Indexing↗

PubMed1993

Assessment of methodologic search filters in MEDLINE.

OBJECTIVE: To determine the retrieval characteristics of methodologic textwords and MeSH terms in MEDLINE for identifying methodologically sound studies on the etiology, prognosis, diagnosis, and prevention and treatment of disorders in general adult medicine. DESIGN: Comparison of methodologic search terms and phrases for the retrieval of citations in MEDLINE with a manual hand search of the literature (the gold standard) for 10 internal and general medicine journals for 1986 and 1991. MEASURES: Sensitivity (proportion of methodologically sound and correct topic studies retrieved) and specificity (proportion of unsound or wrong topic articles not retrieved) of the search strategies. RESULTS: The individual terms yielding the best sensitivity for 1991 by purpose category were: risk (tw) for etiology; exp cohort studies for prognosis; sensitivity (tw) for diagnosis; and clinical trial (pt) for treatment. The corresponding terms for 1986 were: risk (tw) for etiology; prognosis: (tw) for prognosis; sensitivity (tw) for diagnosis; and random: (tw) for treatment. CONCLUSIONS: The performance of methodologic MeSH terms and textwords varied greatly in MEDLINE and changed from 1986 to 1991. More complex search strategies may be required to optimize retrieval.

Information Storage and Retrieval↗

PubMedDate not supplied

Does the goose really lay golden eggs? A methodological review of Workmen's Compensation studies.

OBJECTIVE: To assess the value of workmen's compensation (WC) studies to determine the effectiveness of chiropractic. Therefore, the results of the available WC studies are summarized and the methodological quality of WC studies is discussed. DATA SOURCES: All studies were eligible without time restriction. Studies were identified by a Medline search from 1966 to 1990 (key words: chiropractic, and manipulation-orthopedic in combination with comparative studies, follow-up studies, evaluation studies) by manual examination of the most important chiropractic reference systems (CRAC and Index to Chiropractic Literature), by tracking the reference lists of identified (reviews of) WC studies and by correspondence with researchers. STUDY SELECTION: Studies were regarded as WC studies if by means of databases of WC boards, a comparison was made between claimants treated by chiropractors and those treated by other health care professionals. At least one of the following outcomes should be reported: compensated days, compensation paid or treatment costs. DATA EXTRACTION: Relevant data (authors, year, state, study population, number of patients, days compensated, compensation paid, number of treatments, consultation costs, additional treatment costs and total cost per case) were extracted by one nonblinded observer. The methodological value was reviewed narratively. DATA SYNTHESIS: The retrospective character of WC studies and the use of large WC databases harbor severe methodological problems like incomparability of study groups, absence of information on prognostic indicators, insufficient outcome measures and missing data. The results of older WC studies (before 1980) and the more recent WC studies, which were of better methodological quality, are presented separately. The older studies are in favor of chiropractic. Two of the six more recent WC studies challenge chiropractic effectiveness. CONCLUSIONS: WC studies in general report positive results for chiropractic. Recent results are more ambiguous. Because of the methodological drawbacks identified, WC studies are insufficient to enable a valid study made of chiropractic effectiveness. Therefore, chiropractic (cost-) effectiveness is not yet convincingly proven. More effort should be directed at establishing randomized clinical trials including the question of (cost-) effectiveness.

Accidents, Occupational↗

PubMed1995

The relationship between methodological quality and conclusions in reviews of spinal manipulation.

OBJECTIVE: To study the relationship between the methodological quality and other characteristics of reviews of spinal manipulation for low back pain on the one hand and the reviewers' conclusions on the effectiveness of manipulation on the other hand. DATA SOURCES: Reviews identified by MEDLINE search, citation tracking, library search, and correspondence with experts. STUDY SELECTION: English- or Dutch-language reviews published up to 1993 dealing with spinal manipulation for low back pain that include at least two randomized clinical trials (RCTs). DATA EXTRACTION: Methodological quality was assessed using a standardized criteria list applied independently by two assessors (range, 0% to 100%). Other extracted characteristics were the comprehensiveness of the search, selective citation of studies, language, inclusion of non-RCTs, type of publication, reviewers' professional backgrounds, and publication in a spinal manipulation journal or book. The reviewers' conclusions were classified as negative, neutral, or positive. DATA SYNTHESIS: A total of 51 reviews were assessed, 17 of which were neutral and 34 positive. The methodological quality was low, with a median score of 23%. Nine of the 10 methodologically best reviews were positive. Other factors associated with a positive reviewers' conclusion were review of spinal manipulation only, inclusion of a spinal manipulator in the review team, and a comprehensive literature search. CONCLUSIONS: The majority of the reviews concluded that spinal manipulation is an effective treatment for low back pain. Although, in particular, the reviews with a relatively high methodological quality had a positive conclusion, strong conclusions were precluded by the overall low quality of the reviews. More empirical research on the review methods applied to other therapies in other professional fields is needed to further explore our findings about the factors related to a positive reviewers' conclusion.

Humans↗

PubMed1996

[Can one be a urologist without being familiar with the methodology of therapeutic trials?].

OBJECTIVE: To define the principles of the methodology applied to therapeutic trials in medicine and surgery. To define methodological aspects related to therapeutic trials in urology. To exhaustively study three urology journals in order to analyse the methodological quality of the articles published. METHODS: The basic principles of therapeutic trials are described: the randomized double-blind placebo-controlled trial is the most valid trial to demonstrate the efficacy of a treatment. In surgery, and especially in urology, these therapeutic trials comparing two surgical techniques must be conducted by teams accepting the ambivalence of comparison after randomization. Ideally, treatment is evaluated by observers blinded to the technique used. The assessment criteria must be as clinical as possible and must be based on universally accepted standardized measurements. The quality of a therapeutic trial is assessed in terms of its protocol, but also on the quality of practical conduct of the trial, the precision and accuracy of its statistical analysis and the presentation of the results. The first 1995 issue of the "Journal of Urology", the "British Journal of Urology" and "Progrès en Urologie" were studied exhaustively, looking for articles dealing with a therapeutic evaluation. The comparative or non-comparative nature of the study, the presence or absence of randomization, double-blind, and a predetermined sample size were noted for each study. RESULTS: Ten non-comparative retrospective studies, one non-comparative prospective study and five trials with a control group, including two open randomized trials were reported in the "Journal of Urology". Nine retrospective non-controlled studies were reported in the "British Journal of Urology". Seven retrospective studies, including one open, non-randomized study with a control group, were reported in "Progrès en Urologie". CONCLUSION: The principles of the methodology of therapeutic trials can be applied to the evaluation of a treatment or a surgical technique, especially in urology. Compliance with the rules of methodology impose additional constraints, sometimes difficult to implement, but essential to ensure the quality of the results obtained. Randomized trials are rare in urological publications, which still largely consist of retrospective non-comparative series.

Clinical Trials as Topic↗

PubMed1998

Toxicological risk assessment in the courtroom: are available methodologies suitable for evaluating toxic tort and product liability claims?

Courts are increasingly faced with the need to resolve claims by individuals that they have been injured by chemical exposures or that they have been put at sufficient risk by such exposures that their health status must be monitored to ensure the earliest possible detection of developing injuries or diseases. This paper offers the view that the principles and methods developed and applied by toxicologists, epidemiologists, and risk assessors to support regulatory and public health decision-making are inadequate to evaluate the types of claims that courts are called upon to resolve in such cases. No well-described alternative methodology appears to be available, and as a result, courts are exposed to a wide range of expert opinions based on diverse, conflicting, and sometimes baseless methodologies. It is suggested that there may be value in an effort by the community of professionals in toxicology, epidemiology, and risk assessment to devote attention to the types of data and scientific methodologies that might be appropriate for evaluating the technical questions that such claims provoke. Such an effort might assist trial judges in the role they have been assigned in the Supreme Court's 1993 Daubert decision, wherein they are asked to make a preliminary assessment of the admissibility of the scientific methodologies relied upon by various experts. Such an assessment, if based on an understanding of the types of data and methodologies suitable for evaluating claims of injury, offers the possibility of limiting the range of expert opinion that ultimately is heard in courtrooms to that which conforms to scientifically valid standards.

Dose-Response Relationship, Drug↗

PubMed1998

[Research on diagnostic tests in Medicina Clinica. A methodological assessment].

BACKGROUND: Research on diagnostic tests have not reached the same methodological rigour as other areas of clinical research. Identification of more frequent and important methodological flaws could contribute to raise the quality of diagnostic test studies. The aim of this study was to evaluate the methodology of diagnostic test studies published in MEDICINA CLINICA. MATERIAL AND METHODS: Forty two articles about diagnostic test studies published in MEDICINA CLINICA from 1992 through 1995 were selected. Two set of methodological criteria were applied (JAMA 1995; 274: 645-651 and Revisiones en Salud Pública 1993; 3: 243-262). Each article was independently evaluated by two observers. RESULTS: Of the 42 articles evaluated, 33 determined sensitivity and specificity, and 9 only sensitivity. There was a well-defined gold-standard in the majority of the studies (90%) but it was not applied to all patients in 21% of them. Description of the diagnostic test evaluated was present in 79% and test reproducibility was assessed in only 19%. Source of patients, eligibility criteria for study subjects and spectrum composition were considered in 31, 36 and 31%, respectively. Avoidance of work-up bias and review bias was done in 69 and 36% of the articles. Only 12% considered indeterminate results, 50% reported test indexes for relevant clinical subgroups and statistical precision was provided in 17% of the studies. CONCLUSION: Methodological quality of the research on diagnostic tests published in MEDICINA CLINICA is similar to that observed in the best world clinical journals. Nevertheless, there are opportunities to improve several aspects of study design and presentation that will facilitate its clinical applicability and general utility.

Diagnostic Techniques and Procedures↗

PubMed1994

A methodology for estimating the contribution of malnutrition to child mortality in developing countries.

According to conventional methods of classifying cause of death, approximately 70% of child deaths (0-4 y) worldwide are due to a small number of priority infectious diseases which, in turn, receive the vast majority of donor and national resources in the health sector. Despite the long-recognized synergism between malnutrition and infection in the causation of child mortality, malnutrition does not appear as a major cause of death in health statistics from developing countries. Part of the reason for this has been the difficulty of estimating the percent of deaths due to malnutrition, because the conventional methods of classifying cause of death do not recognize the potentiating effect of malnutrition on the disease. The purpose of this paper is to develop and test a simple methodology to estimate the percent of child deaths in a given country or community that is due to malnutrition's potentiating effects on prevailing infectious diseases. The cornerstone of the methodology is knowledge of the strength of the association between malnutrition and mortality in developing countries, as measured in eight prospective studies. These studies reveal remarkable consistency in relative risk across different grades of malnutrition. The mean and SE of relative risk for severe malnutrition is 8.4 +/- 2.1, for moderate malnutrition it is 4.6 +/- 0.9, and for mild malnutrition it is 2.5 +/- 0.3. When applied to survey data from Ethiopia, Malawi, Guatemala and India for illustrative purposes, this methodology indicates that 42-57% of all child deaths in these samples (6-59 mo) are due to malnutrition's potentiating effects on infectious disease, of which 76-89% is attributable to mild-to-moderate malnutrition. This methodology is recommended for use in a variety of policy and planning applications.

Child, Preschool↗

PubMed2006

Methodological and ethical issues in conducting qualitative research with children and young people: a literature review.

BACKGROUND: There is an increasing interest in involving children in research that has been influenced by the recognition of children's rights and by the reconceptualisation of children within the social sciences as active agents rather than as the objects of research. OBJECTIVES: To review the methodological and ethical issues involved in conducting qualitative research with children and to consider the implications for nursing research in light of recent debates within the social sciences. DESIGN: Narrative literature review using a systematic search of computerized databases. DATA SOURCES: Published papers, key texts, reports and policy documents that relate to the methodological and ethical issues in conducting qualitative research with children. RESULTS: There are three ethical issues in relation to conducting research with children: power relations, informed consent and confidentiality. Two key methodological issues are identifiable in relation to conducting research with children. One is epistemological and relates to the different cultures of childhood and adulthood and the second relates to the heterogenous nature of childhood itself. Novel techniques and task-based activities are being increasingly used to establish rapport and as a method of data collection. CONCLUSION: There are both differences and similarities in conducting qualitative research with children and with adults but often the similarities have been overlooked and the differences overstated. Nursing and other health-related researchers conducting research with adults could learn much from children's researchers, particularly in terms of sensitivity to ethical issues. Nursing research need to consider the methodological issues that have been debated in the social sciences and to critically reflect on the use of novel techniques in qualitative research.

Adolescent↗

PubMed1997

Methodological issues conducting sensitive research on lesbian and gay men's experience of nursing care.

This paper is a methodological discussion on a qualitative research project which involved interviewing lesbians and gay men about their experiences of nursing care. The research project arose primarily because most of the knowledge available on the subject was based on hearsay and anecdote. It is worthy of note that those who felt there was an issue to be addressed, as well as the bearers of anecdote, were by and large what would be termed 'insiders' in ethnographic research, and zealots with an axe to grind in less academic circles. It is the nature of this "insider' status which is of interest throughout the research process of what was and remains a sensitive research topic. 'Insider' status can reduce many of the problems associated with conducting sensitive research in terms of access, rapport with subjects, ethical concerns, and stigma contagion, but by the same token lays researchers open to the charge of bias thought to be inherent in going native, or rather in this case being native. However, there are some problems associated with 'insider' status as well and this paper offers a discussion of the methodological problems we have encountered in relation to this, as well as more general methodological issues when conducting research considered to be sensitive. Ethical dilemmas also arose during the research when lesbian and gay patients who were currently receiving hospital care contacted the researchers directly because they felt threatened by nursing and medical staff. The paper is an attempt to describe some fairly conscious strategies to use the research team's 'insider' status for methodological reasons and to explain the ethical position we took when we felt compromised.

Attitude of Health Personnel↗

PubMed1998

Phenomenologies as research methodologies for nursing: from philosophy to researching practice.

This paper is concerned with the popularity of phenomenologies and the tensions that arise from their use as research methodologies in nursing. Among these tensions are: the troublesome issues of adapting a fundamentally philosophical means of understanding human being(s) for use as a more pragmatic and robust research approach in a practice discipline; the various types of phenomenology and the confusions that surround these and other interpretive methodologies, particularly within different intellectual and cultural traditions; and the need for nursing to find a space in which it can give voice to aspects of its practice that are silenced in less existentially oriented methodologies. Although phenomenologies are currently popular and possibly fashionable in nursing, there are important issues in relation to their use in a methodological sense that remain to be addressed.

Culture↗

PubMed1996

Nursing research methodology: transcending Cartesianism.

Nurses involved in research are concerned with methodological issues. This paper explores the Cartesian debate that has polarized the discourse on nursing research methodology. It is argued that methodologies exclusively based on objectivism, one pole of the Cartesian debate, or subjectivism, the other, do not provide nurses with adequate research foundations to understand the complexity of the lifeworld of nursing practice. This paper provides nurse researchers with an alternative methodological perspective, Gadamerian hermeneutics, which is in harmony with the clinical world of nursing practice.

Humans↗

PubMed2026

Mixed Methods Research on Family Caregiving for Stroke Survivors: A Methodological Systematic Review.

AIM: To examine how mixed methods research has been applied in studies of family caregiving for stroke survivors, focusing on key methodological components (rationale, design types, integration strategies, and use of joint displays). DESIGN: Methodological systematic review. METHODS: A systematic search of five databases yielded 17 studies. The extraction focused on mixed methods features (rationale, design, integration, joint displays), and quality was appraised using the Mixed Methods Appraisal Tool. DATA SOURCES: PubMed, CINAHL, Scopus, Web of Science, and PsycINFO were searched for relevant studies published from 2010 to 2025. RESULTS: The included studies addressed topics such as caregiver burden, coping, resilience, and intervention outcomes. Convergent and explanatory sequential designs predominated. Complementarity was the most frequent rationale for mixing methods. Integration occurred mainly through merging, with fewer instances of connecting or building. Three studies included joint displays to integrate the results. CONCLUSION: Mixed methods research is increasingly applied in family caregiving. To advance the field, researchers should strengthen integration during analysis and results and improve transparency in reporting key design features. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Strengthening methodological rigour in mixed methods studies on stroke caregiving will improve the evidence base for nursing practice. Intentional and meaningful integration of qualitative and quantitative evidence can better inform effective interventions and support programs, ultimately enhancing care for stroke survivors and their families. IMPACT: This review evaluates how mixed methods research is applied in family caregiving studies. It identifies significant methodological gaps, including unclear reporting of design and limited use of advanced integration techniques. The recommendations provide practical guidance for researchers to improve reporting and integration, yielding richer evidence to inform interventions and policies that support family caregivers. REPORTING METHOD: The review followed the PRISMA 2021 guidelines for transparent reporting of systematic reviews. PATIENT OR PUBLIC CONTRIBUTION: No patient or public involvement.

Humans↗

PubMedDate not supplied

Using focus group methodology in nursing.

BACKGROUND: The need to obtain quality data in a cost-efficient manner spawned an exploration of research methods. The value of focus group methodology for multiple roles in nursing became evident. METHOD: This article describes the purpose, process, and application of focus group methodology for nursing continuing education. RESULTS: Ideas for use of focus group methodology in nursing continuing education are suggested. CONCLUSION: Focus group methodology can enhance the work of nurses in continuing education roles.

Cost-Benefit Analysis↗

PubMed2000

The methodological journey of a grounded theorist: an interview with Denise Dignam. Interview by Lynne S. Giddings, Pamela J. Wood.

Nurses and midwives in Aotearoa/New Zealand are making a unique contribution to the development and application of various research approaches (methodologies) to nursing and midwifery practice. This is the first of a series of articles based on interviews with nursing and midwifery researchers, giving stories of their research journeys in relation to a particular methodology. The articles will give beginning researchers some real life examples of what it is like to carry out research. They are not in-depth explorations of the various methodologies. What we have attempted to capture is how real people actually use the various research methodologies we read about in textbooks and that frame the research which influences our practice. The stories are presented in interview format so that each interviewee's unique style and approach can emerge. The first researcher in our series is Denise Dignam (RGON, BA, DipSocSci) who in her PhD research is using a grounded theory approach to investigate issues related to breastfeeding.

Humans↗

PubMed2004

Caliber of quality-of-life assessments in congenital heart disease: a plea for more conceptual and methodological rigor.

BACKGROUND: Interest in quality-of-life issues in children, adolescents, and adults with congenital heart disease has increased significantly during the past decades. In general, quality-of-life research is stimulated by an overall interest in outcomes. More specifically, quality-of-life studies add to mortality and morbidity data by taking reported physical, psychological, and social problems into consideration. However, quality of life can be an ambiguous concept that is hindered by methodological weaknesses, a situation that can prevent the drawing of firm conclusions. OBJECTIVE: To appraise the conceptual and methodological rigor of published quality-of-life assessments in patients with congenital heart disease. DESIGN: A review of 70 articles published in the medical literature, using the 10 criteria previously developed by Gill and Feinstein. For each criterion, the number of articles complying with that criterion was counted, and the percentage was calculated. To indicate how well individual articles performed on the respective criteria, a summary score was calculated by summing the number of criteria an article fulfilled and dividing this sum by the number of criteria for which the article was eligible to be evaluated; the resulting value was then multiplied by 100. MAIN OUTCOME MEASURE: Summary scores ranging from 0, for articles complying with none of the criteria, to 100, for articles complying with all of the criteria. RESULTS: We found that quality-of-life assessments in patients with congenital heart disease showed major conceptual and methodological drawbacks (median summary score, 0). Moreover, we found that the term quality of life was often used inappropriately, an observation supported by several articles in which the authors drew conclusions about patients' quality of life, even though quality of life was not specifically measured. CONCLUSIONS: A poor conceptual and methodological basis for quality of life implies that many results from quality-of-life studies performed in patients with congenital heart disease contribute little to the scientific knowledge base of quality of life in this patient population. Future quality-of-life studies need to invest in a rigorous conceptualization, an adequate operational definition, and a sound measurement of quality of life.

Adolescent↗