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PubMed2004

Evaluation of empirical methods and methodological foundations of human left-handedness.

The methodological and empirical foundations underlying the theories on human left-handedness are examined, including the definition and classification of left-handedness, its relation to pathology, and the results on family, adoption, and twin research. It is argued that major research findings on left-handedness are based on inadequate empirical methods, and the concrete definitions and assessment procedures do not meet validity and reliability criteria. This also casts doubt on the relationship between left-handedness and pathology reported in the literature. Furthermore, findings from family, adoption, and twin studies do not allow interpretation of possible direct genetic contributions to explaining left-handedness. It is concluded that the methodological limitations of a causal explanation should encourage an examination of the epistemological and methodological premises of theory formulation. The functional method and a theoretical framework based on early childhood experiences and the neural plasticity of the brain may be more appropriate for the selection of empirical methods in research of human left-handedness.

Brain↗

PubMed2006

Approaches to occupational health based on participatory methodology in small workplaces.

An intervention based on the methodology developed by the International Labour Office, the Work Improvement in Small Enterprises (WISE) was carried out to improve work condition of small-scale enterprises and the informal sector in the Philippines, Thailand and Japan. Through the evaluation of the efficacy of the approaches based on participatory methodology, it is concluded that the method is an efficient measure to improve work condition in small workplaces. It is also pointed out that the activities of supporting experts such as introduction of the methodology and evaluation of the activity are necessary. The important roles of the experts are 1) to encourage managers and workers to sustain the activities for work improvement, 2) to analyse the effectiveness and problems of the implemented improvements, 3) to give appropriate suggestions for the further improvement, and 4) to get materials for demonstrating the effectiveness of WISE activities on improving work conditions and productivity to other managers and workers who have not participated in the activity.

Cooperative Behavior↗

PubMedDate not supplied

[Clinical trials using medicinal plants: bibliographical review and methodological analysis].

BACKGROUND: The importance of traditional medicine, one of the fundamentals of the cultural heritage of African, Asian and South American peoples, is evident in that such medicine is practised by more than 80% of these populations. METHODS: To analyse the methodology of clinical trials using medicinal plants, we reviewed articles published on this topic between 1980 and 2000. RESULTS: Forty-eight clinical trials were identified. Most were carried out in developed countries. Standard methodological principles were applied in almost all the trials: randomisation (85.4%), comparison (87.5%) versus placebo (95.2%), and blinded design (81.3%). The duration of the studies was short. Sample sizes were generally small, ranging from 30 to 99 subjects; statistical tests were used in 90% of the trials. Adverse effects were infrequently collected. CONCLUSION: Most clinical trials included in this survey were conducted in accordance with WHO guidelines. Respect for methodological principles and the implementation of a legislative framework are important in obtaining credibility and international recognition of the traditional pharmacopoeia.

Clinical Trials as Topic↗

PubMed1994

A researcher's guide to investigating the psychological sequelae of infertility: methodological considerations.

Research into the psychological sequelae of infertility has been plagued by a number of methodological problems. The most common methodological concerns involve conceptual confusion regarding the measurement and existence of psychiatric morbidity among the infertile, selection of convenience samples which limit generalizability, and failure to analyze the influence of important variables like diagnosis, treatment length, dyadic concordance and dyadic patterns. These methodological limitations are detailed and recommendations are made for future research.

Confounding Factors, Epidemiologic↗

PubMed1989

New diagnostic tools and methodological approaches: an outlook to the future.

In spite of recent progress, the aetio-pathogenesis of a large number of osteoarticular diseases is as yet not well known. This is apparent for commonly occurring diseases such as osteoarthritis (OA), rheumatoid arthritis (RA), type I osteoporosis (post-menopausal) and type II osteoporosis (senile). As a result of the lack of knowledge about these pathogenic factors, therapeutics often remain symptomatic and not completely satisfactory. Nowadays there is a need for methodological tools to explore the causes or pathogenic factors of these conditions. Moreover, in OA, there is at present no way to predict the development of this disease and to follow its evolution, hence, there is a need for specific markers. These biological and methodological developments are useful for searching for new molecules able to compensate for the pathogenic anomalies demonstrated in RA and OA. In this paper, we will discuss some of the methodological developments now in progress which may provide solutions to some of the aetiopathogenic, diagnostic and therapeutic problems related to RA and OA.

Arthritis, Rheumatoid↗

PubMed2004

A methodology for verification of radiotherapy dose calculation.

OBJECT: A methodology for dosimetric verification of radiation therapy plans was developed and implemented. Dosimetric accuracy of clinically active intensity-modulated radiotherapy (IMRT) and intensity-modulated radiosurgery (IMRS) programs was assessed using this methodology. METHODS: The methodology included several dosimetric tasks that were performed to assess the dosimetric accuracy of a treatment plan. Absolute dosimetry of the composite plan was performed using an ionization chamber. Film dosimetry was performed for each individual field and for the multifield composite plan. Calculated dose distributions and film measurements were compared using software developed for the specific tasks. Two-dimensional maps of gamma index, dose difference, and distance-to-agreement were calculated and displayed. To date, good agreement between measurements and calculations has been observed in 160 clinical IMRT and IMRS plans. The largest observed absolute dose disagreement was -4.79%. The mean absolute dose difference was 0.26%, with a standard deviation of 1.75%. The authors specify a 3% dose difference and 3-mm distance as the scaling acceptability criteria for the gamma index calculations of the film measurement analysis. The planning and delivery system in clinical use has proven consistently to satisfy these criteria. CONCLUSIONS: The dosimetric verification methods and the software tools developed were both quantitative and clinically practical. The measurements and the analysis demonstrated that the IMRT and IMRS planning and delivery system in use was sufficiently accurate for highly conformal treatments.

Film Dosimetry↗

PubMed2006

Methodological issues in the psychology of religion: toward another paradigm?

Recent evaluations have identified the psychology of religion as a field in crisis and have called for a new multilevel interdisciplinary paradigm. However, a critical meta-perspective on methods reveals a broad range of methodologies, each appropriate for particular levels of complexity in the psychology of religion. No single methodology is appropriate for every level, nor can higher levels of complexity be explained by data from lower levels. The authors identify the different types of research practiced in the psychology of religion and critically discuss philosophical presuppositions involved in two major methodological traditions, the empiricist-analytical and the hermeneutical, often identified as quantitative and qualitative traditions, respectively.

Forecasting↗

PubMed2003

Focus group methodology: explanatory notes for the novice nurse researcher.

Focus group methodology is a qualitative research approach that provides the potential for authentic quality data to be captured by using the candour and spontaneity of participants in an atmosphere of dynamic group interaction. The use of this methodology within nursing research is growing as it provides a qualitative approach that can produce quality data and can be used effectively by both experienced and novice researchers. The purpose of this paper is to provide guidance to the novice nurse researcher who may be considering using this methodology so that appropriate use is promoted and practical advice for its use may generate quality data.

Focus Groups↗

PubMed2002

Is volume related to outcome in health care? A systematic review and methodologic critique of the literature.

PURPOSE: To systematically review the methodologic rigor of the research on volume and outcomes and to summarize the magnitude and significance of the association between them. DATA SOURCES: The authors searched MEDLINE from January 1980 to December 2000 for English-language, population-based studies examining the independent relationship between hospital or physician volume and clinical outcomes. Bibliographies were reviewed to identify other articles of interest, and experts were contacted about missing or unpublished studies. STUDY SELECTION: Of 272 studies reviewed, 135 met inclusion criteria and covered 27 procedures and clinical conditions. DATA EXTRACTION: Two investigators independently reviewed each article, using a standard form to abstract information on key study characteristics and results. DATA SYNTHESIS: The methodologic rigor of the primary studies varied. Few studies used clinical data for risk adjustment or examined effects of hospital and physician volume simultaneously. Overall, 71% of all studies of hospital volume and 69% of studies of physician volume reported statistically significant associations between higher volume and better outcomes. The strongest associations were found for AIDS treatment and for surgery on pancreatic cancer, esophageal cancer, abdominal aortic aneurysms, and pediatric cardiac problems (a median of 3.3 to 13 excess deaths per 100 cases were attributed to low volume). Although statistically significant, the volume-outcome relationship for coronary artery bypass surgery, coronary angioplasty, carotid endarterectomy, other cancer surgery, and orthopedic procedures was of much smaller magnitude. Hospital volume-outcome studies that performed risk adjustment by using clinical data were less likely to report significant associations than were studies that adjusted for risk by using administrative data. CONCLUSIONS: High volume is associated with better outcomes across a wide range of procedures and conditions, but the magnitude of the association varies greatly. The clinical and policy significance of these findings is complicated by the methodologic shortcomings of many studies. Differences in case mix and processes of care between high- and low-volume providers may explain part of the observed relationship between volume and outcome.

Delivery of Health Care↗

PubMed1998

A methodology for examining the plausibility of accelerated aging protocols for UHMWPE components.

In light of the time-intensive nature of using real-time shelf-aged specimens in research into property changes of ultra-high-molecular-weight polyethylene (UHMWPE), accelerated thermal diffusion oxidative aging (usually referred to as accelerated aging) is frequently resorted to. A number of such aging protocols have been reported in the literature, with various claims for their producing changes in the properties of the polymer being the same as or similar to those seen in real-time shelf-aged samples. The thrust of the present work is the presentation of a methodology for examining such claims. The methodology is applied to six properties (% crystallinity, melting temperature, oxidation index, ultimate tensile strength, ultimate tensile elongation, and tensile toughness) of 4150HP UHMWPE grade, sterilized using six different methods, prior to and following the use of a specific accelerated aging protocol (oxygen gas at 70 degrees C and 507 kPa pressure; 14 d.). These six properties have been identified in the literature as being strongly correlated with the clinical wear of UHMWPE articular components. It is shown that the claim for the protocol used in the present work (in terms of the simulated equivalent shelf aging time) is plausible. It needs to be emphasized, however, that this conclusion is tentative given the paucity of the relevant literature results that are currently available and which are vital to the application of the methodology.

Biocompatible Materials↗

PubMed1997

A cooperative methodology to build conceptual models in medicine.

We designed a methodology to perform distribute activities on conceptual modelling among cooperating centers. Our methodology assigns responsibilities and tasks and regulates interactions preserving coherence; it passes through the construction of unambiguous paraphrases to make explicit the context within the original sources, and through their compositional representation in an intermediate language. The process is intrinsically iterative, with continuous feedbacks and refinements, alternating analytic view on details and synthetic view on regularities and structures. Our methodology is based on requirements and experience made in the first GALEN project, and was applied in the GALEN-IN-USE project to coordinate modelling activities of three teams of surgeons in Rome with activities of other partners, during the production of an extensive model of surgical procedures.

Humans↗

PubMed1999

A methodological approach towards the design of a highly innovative wheelchair with enhanced safety, manoeuvrability and comfort.

This paper presents the methodological framework for the development of an innovative wheelchair able to solve the problem of use within all transportation modes (car, bus, train, ship, aeroplane). This task calls for a multi-step integrated methodology in order to gather and reconciliate conflicting user needs and requirements regarding safety, manoeuvrability and comfort. The paper describes also the methodology adopted for the system architecture of a modular design wheelchair as well as for its evaluation, ranging from crash tests (both simulations and real tests) to vibration and comfort studies. The work stems from the research conducted in the TRANSWHEEL project (DE 3013), partly financed by the European Union's DE/TAP programme.

Equipment Design↗

PubMed1982

Methodological factors in studying medical graduates: a review of six internship performance studies.

This "state of the art" article examines six internship performance studies of medical school graduates that use rating scales as the vehicle for data collection. The methodological decisions investigators faced in designing the studies are described and the range of options used is illustrated. The content and format of rating forms employed are compared. No methodological standards currently exist for internship performance studies. We call for greater attention to methodological issues in study design, including examination of potential sources of bias. How structural aspects of the internship performance study design may influence the results obtained needs careful study.

Clinical Competence↗

PubMed1999

[The practice of systematic reviews. III. Evaluation of methodological quality of research studies].

The methodological quality of the primary studies included in a systematic review may influence its results and final conclusions. Methodological quality may be defined in various ways. Partially because of this there are many different assessment lists. The most important dimension of quality is internal validity, defined as the confidence that the design, performance and report of a trial prevent or reduce systematic errors (bias) in the outcomes. For only a limited number of internal validity items a relationship with bias has been proven in empirical studies: concealment of randomisation and blinding of patients and outcome assessors. Preferably, quality should be assessed by at least 2 assessors independently. There is no consensus whether assessment should be done blinded for authors, journal, results and conclusions. Internal validity can be incorporated into statistical pooling in various ways: as a selection criterion, to be used as weight or to hierarchically order studies in a presentation. Well-designed comparative studies are needed to provide clearer guidelines for methodological assessment in the future.

Bias↗

PubMed1999

[Examples and proposed solutions for methodological problems in hospital appropriateness assessment].

Inappropriate hospital care has become a recurring theme since the publication of the results of the model project on the appropriateness of hospital care (Section 275 a SGB V) by the medical service of the National Associations of Health Insurers (MDS) in Spring 1997. Nationwide, an increased number of appropriateness assessments have since been conducted by the medical service of the health insurers (MDK). The basis for an objective assessment of the appropriateness of hospital care is a diligent, comprehensive, and methodologically valid examination of the actual situation. At first, it was unknown to what extent current methods in Germany conformed to international scientific standards in Epidemiology, Biometry, and Health Services Research. Following a thorough scientific examination of several typical methodologies, it became clear that current methods are insufficient, and hence do not allow valid conclusions regarding inappropriate hospital admissions or hospital days. This statement does not deny that inappropriate hospital use is very likely, but our current assessment tools do not permit further conclusions to be drawn. The purpose of this article is to identify typical mistakes in the fundamental aspects of a valid assessment based on selected examples. Proposals are made regarding methodology and the presentation of results that follow from this critical examination.

Germany↗

PubMed1998

[The end-of-study dissertations in nursing schools. Pedagogic and methodologic considerations].

The writing of the study end dissertation, in the degree course of the student nurses poses pedagogical as well as methodological problems. The goal of the study end dissertation, if this latter takes the form of a research, is not a production of knowledge, but a methodological and conceptual learning. The critical analysis of 142 study end dissertations highlights a level heterogeneousness, a total lack of research problematics and unsuitable methodologies. The study end dissertation does not take the form of a research but of a reflection work, chosen by the student.

Academic Dissertations as Topic↗

PubMed1999

[Health status and functional limitations in the elderly population of the University Region of Health of Puerto Rico: methodologic aspects and prevalence estimates].

In order to plan the health services for the elderly population, it is necessary to quantify their health status and their functional capacity. In Puerto Rico, few epidemiological studies have been conducted regarding functional capacity and chronic diseases in the elderly population. One of the difficulties to undertake these studies is the high cost and risks to move this population for clinical exams, in addition to the methodology limitation of self-report in the elderly population. This study shows the use of logistic regression to estimate the prevalence of chronic diseases and functional capacity, when the observed data are not consisted with the planed sampling scheme. Four hundred and eighty-seven elderly persons (65 yr. and over) were interviewed in the municipalities of Canóvanas, Carolina, Loíza and Trujillo Alto in Puerto Rico, using a cross-sectional design. More than half of the elderly had visual problems (IC 95%: 54.8%, 63.8%), arthritis (IC 95%: 52.7%, 61.5%) and hypertension (IC 95%: 47.3%, 56.3%). In the case of hypertension, significant differences (p < 0.05) by sex were observed, where women reported a higher prevalence than men. One of the higher prevalences in the functional capacity status was with urine accidents. More than one-third of the population is estimated to have this problem (IC 95%: 34.7%, 43.4%). One-fourth of the population had limitations with going out for shopping (IC 95%: 23.9%, 31.9%) and using public and private transportation (IC 95%: 19.5%, 26.9%). We conclude that the applied methodology was consistent with the estimation presented in the literature and statistics from the Puerto Rico Health Department. However, it is necessary to continue assessing the design and analytical methodology, in order to undertake consistent and periodic evaluations of the elderly population.

Activities of Daily Living↗

PubMed2000

A prevalence methodology for mental illness and developmental disorders in rural and frontier settings.

A prevalence study methodology developed for use in rural and frontier settings is described. The general method was developed over a 15 year period and has been successfully adapted and used in studies of 14 different childhood onset developmental disorders. Subjects were the 168,000 school aged children from North Dakota who were first surveyed for cases of autism--pervasive developmental disorders in 1985 and 1986. The results of the prevalence study were compared with the results of a 12-year ongoing surveillance of the cohort. The 12-year ongoing surveillance identified one case missed by the original prevalence study. Thus the original prevalence study methodology identified 98% of the cases of autism-pervasive developmental disorder in the population. This methodology may also be useful for studies of other developmental disorders in rural and frontier settings.

Adolescent↗