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PubMed1998

Incidence studies of primary and secondary intracranial tumors: a systematic review of their methodology and results.

We reviewed the incidence studies of intracranial tumors to compare their methodology and identify whether there was evidence of true differences in incidence by time, place, age, or sex. Studies were identified from Medline (1966-95), bibliographies of relevant articles, and personal knowledge. For each study, various methodological details were recorded, along with the age-standardized incidence of all primary tumors and the crude and age/sex-specific incidences of different types of intracranial tumor. Methodological factors which significantly influenced the reported incidence were identified and the results of different studies were compared and combined in a meta-analysis if appropriate. Twenty studies (over 20,000 primary tumors) were included. Higher incidences of primary tumors were found in studies that: used many methods to identify cases (odds ratio [OR] 1.92); included a high percentage of asymptomatic patients (OR 2.03); did not require histologic confirmation of the diagnosis (OR 1.69). Studies from the 1980's reported higher incidences than in previous decades (OR 1.51), probably because of improved methodology. Comparable studies from the 1980's gave widely different incidence rates for all primary tumors (7.1-18.6 per 100,000 per year). In all studies, the incidence of neuroepithelial and meningeal tumors increased dramatically with age. Neuroepithelial tumors were 40% more common in men, whilst meningeal and cranial nerve tumors were about 80% and 40% more common in women, respectively. Further incidence studies are required to establish geographical and secular variations in the incidence of primary intracranial tumors but these must use comparable methodologies. Provisional guidelines for future studies are given.

Age Distribution↗

PubMed2001

Identification and classification of key variables and their role in environmental impact assessment: methodology and software package INTRA.

There is, as yet, no proven methodology to enable, objectively, the identification of key parameters out of a large number one normally encounters during any EIA. As EIA is a costly and time-consuming exercise, it is necessary to separate the man from the boys--so to speak--in order to optimize costs and efforts. In this paper a methodology for distinguishing the more important parameters from the less important ones, developed by us, is described. The methodology aims at identifying and shortlisting the key parameters which ought to be studied in a given EIA situation, thereby helping in reducing time, effort, and cost of EIA. With this methodology a system structure is developed which gives hierarchical pattern of inter-parameter interaction, and reveals several distinguishing features of each parameter. A software package INTRA (INTer-parameter Relationship Analysis) based on this methodology, has been developed. The paper also describes a case study in which INTRA has been used to study the environmental impacts of urbanization of a typical third world town (Roorkee).

Developing Countries↗

PubMed2001

Empirical evaluation and justification of methodologies in psychological science.

The purpose of this article is to describe a relatively new movement in the history and philosophy of science, naturalism, a form of pragmatism emphasizing that methodological principles are empirical statements. Thus, methodological principles must be evaluated and justified on the same basis as other empirical statements. On this view, methodological statements may be less secure than the specific scientific theories to which they give rise. The authors examined the feasibility of a naturalistic approach to methodology using logical and historical analysis and by contrasting theories that predict new facts versus theories that explain already known facts. They provide examples of how differences over methodological issues in psychology and in science generally may be resolved using a naturalistic, or empirical, approach.

History, 17th Century↗

PubMed1998

Investigating psychosocial aspects of participation in early anti-cancer drug trials: towards a choice of methodology.

This paper presents the methodological approach and research methods chosen to explore psychosocial aspects of participation in early anti-cancer drug trials from the perspective of those actually involved. The paper describes how an appropriate methodology, or principles of reasoning behind the choice of research methods, emerged. The choice of methodology was based on three elements: first, an understanding of the competing philosophies about how research can be approached and conducted; second, the author's view of the subject area; and third, a consideration of previous research approaches which have investigated psychosocial aspects of cancer clinical trials. A qualitative methodology situated within an interpretative paradigm was eventually chosen as the most appropriate means of exploring trial participants' experiences and the aim and objectives of the research were developed within this methodological framework.

Antineoplastic Agents↗

PubMed2001

Methodologies analysing individual practice in health care: a systematic review.

AIM OF THE REVIEW: The aim of the systematic review was to identify, explore and evaluate the current level of knowledge of methodologies used in comparative analyses of the individual practice of doctors, nurses and midwives. RATIONALE: The question of how roles and responsibilities might be shared differently between professional groups in order to promote improved, cost-effective health care requires a systematic analysis of existing roles and practice. To do this effectively, knowledge of the methodologies available for such an analysis is essential. METHODS: A systematic review of the literature published since 1989 comparing the practice of doctors, nurses and midwives was undertaken. FINDINGS: The findings are presented in tabular format and include the following categories of published methodologies: experimental/quasi-experimental; descriptive/nonexperimental and qualitative studies. The discussion centres on a critique of quantitative methodologies used to analyse individual practice in relation to role substitution and diversification. The potential contribution of qualitative methodologies in the analysis of individual practice is discussed. CONCLUSIONS: The authors conclude that the current level of knowledge is biased towards quantitative research. It is argued that the assessment of health care roles and responsibilities would be well served by a more balanced approach that recognizes the strengths of both quantitative and qualitative work.

Humans↗

PubMed1996

Diagnostic tests for temporomandibular disorders: an assessment of the methodologic quality of research reviews.

SUMMARY. The objective of this study was to assess review articles of temporomandibular disorder (TMD) diagnostic tests for methodological quality and to establish the need for a systematic reviewing process. Computerized bibliographic database searches from 1983 to December 1996, information requests from authors, and review of reference lists of all retrieved reports were used to identify relevant reviews. After applying selection criteria, two investigators independently reviewed the articles. Each review article was evaluated independently for methodological quality. Agreement between reviewers was measured using quadratic weighted kappa.Forty-five of 53 review articles met the selection criteria. No review described the search methods, selection criteria, demonstrably avoided selection bias or pooled data of primary studies. Three of 45 articles assessed the internal validity and reliability of the studies included in their review. Major to extensive methodological flaws were noted across all reviews.This critique of methodologic quality in TMD diagnostic review articles supports the need for a systematic reviewing process. Clinicians turning to diagnostic reviews to aid them in synthesizing a large body of literature may wish to apply the described methodologic criteria to separate 'valid' from 'invalid' reviews. Copyright 1996 Harcourt Publishers Ltd.

Journal Article↗

PubMed2004

[Validity of risk calculations in offenders -- criticism of a basic methodological assumption, and future perspectives].

Catalogs of multidimensional criteria have become established in continental Europe. In contrast, due to the limited reliability of clinical prognoses, procedures such as "Actuarial Risk Assessments" have been established in Anglo-Saxon countries as a means of assessing prognoses. The basic assumptions of "Actuarial Risk Assessments" (principally a statistical methodology) show a remarkable discrepancy compared with the fundamental ideas of the European experts (clinical assessment procedures), although this has not to date been discussed in depth in the literature. Apart from this discrepancy, however, certain basic assumptions are internationally regarded as generally accepted methodological cornerstones of prognostic theory. Thus, such a generally unchallenged "essential" methodological principle as the "Two by Two Table" has been mentioned for many years in a dichotomous sense in numerous textbooks or basic lecture on prognostic theory. Far-reaching conclusions concerning the validity of prognostic statements are made on the basis of this methodological axiom. Thus, the putative error rate for prognostic assessments is derived from so-called "false positive prognoses", and, among other things, the unjustified committal of offenders wrongly judged to be dangerous is criticised. Surprisingly, there is no discussion in the considerable literature currently available, that it is methodologically highly questionable to use the Two by Two Table that is adequate for dichotomous decision-making, without using further differentiation with respect to probability factors, as is undoubtedly the case for risk calculations. The article discusses the above mentioned problems and gives possible approaches for solutions.

Actuarial Analysis↗

PubMed2002

Rapid assessment of trachoma in Hainan Province, China: validation of the new World Health Organization methodology.

This study was undertaken to validate a WHO methodology for the rapid assessment of trachoma. Fourteen villages were chosen by random sampling in two counties in Hainan Province, China. For the rapid assessment, trichiasis patients were identified, 50 children ages 1-10 years were examined for active trachoma, and information was collected on community access to services and community risk factors. To validate the methodology, a prevalence survey was undertaken simultaneously in the same villages. For the prevalence survey, 2428 people from 1606 households in the 14 villages were chosen by random sampling. Very little active trachoma was found by either method, although the rates of trichiasis were more substantial. Ranking of the villages by the two methods for trichiasis was highly correlated (Spearman's correlation coefficient = 0.60, p = 0.02). For active trachoma, the Spearman's correlation coefficient for the ranking of villages by the two methods was 0.40 and not significant (p = 0.14), suggesting that a correlation this close may have been seen by chance alone. The observational data showed all the villages to be at risk of active trachoma (due to poor environmental hygiene conditions), suggesting that this aspect of the WHO methodology overestimates the risk for active trachoma. We conclude that, with the exception of the community assessment of risk, this rapid assessment methodology is a valid tool for the assessment of trichiasis and possibly of active trachoma in rural communities, although the level of active trachoma in this study was too low to effectively validate that aspect of the methodology.

Child↗

PubMed2006

Methodology of management of dredging operations II. Applications.

This paper presents the new methodology of management of dredging operations. Derived partly from existing methodologies (OECD, PNUE, AIPCN), it aims to be more comprehensive, mixing the qualities and the complementarities of previous methodologies. The application of the methodology has been carried out on the site of the Port of Dunkirk (FRANCE). Thus, a characterization of the sediments of this site has allowed a zoning of the Port to be established in to zones of probable homogeneity of sediments. Moreover, sources of pollution have been identified, with an aim of prevention. Ways of waste improvement have also been developed, to answer regional needs, from a point of view of competitive and territorial intelligence. Their development has required a mutualisation of resources between professionals, research centres and local communities, according to principles of industrial ecology. Lastly, a tool of MultiCriteria Decision-Making Aid (M.C.D.M.A.) has been used to determine the most relevant scenario (or alternative, or action) for a dredging operation intended by the Port of Dunkirk. These applications have confirmed the relevance of this methodology for the management of dredging operations.

Algorithms↗

PubMed2004

A quality evaluation methodology of health web-pages for non-professionals.

PRIMARY OBJECTIVE: The proposal of an evaluation methodology for determining the quality of healthcare web sites for the dissemination of medical information to non-professionals. METHODS AND PROCEDURES: Three (macro) factors are considered for the quality evaluation: medical contents, accountability of the authors, and usability of the web site. Starting from two results in the literature the problem of whether or not to introduce a weighting function has been investigated. This methodology has been validated on a specialized information content, i.e., sore throats, due to the large interest such a topic enjoys with target users. The World Wide Web was accessed using a meta-search system merging several search engines. A statistical analysis was made to compare the proposed methodology with the obtained ranks of the sample web pages. MAIN OUTCOME AND RESULTS: The statistical analysis confirms that the variables examined (per item and sub factor) show substantially similar ranks and are capable of contributing to the evaluation of the main quality macro factors. A comparison between the aggregation functions in the proposed methodology (non-weighted averages) and the weighting functions, derived from the literature, allowed us to verify the suitability of the method. CONCLUSIONS: The proposed methodology suggests a simple approach which can quickly award an overall quality score for medical web sites oriented to non-professionals.

Attitude to Computers↗

PubMed2005

Evaluation of community-based injury prevention programmes: methodological issues and challenges.

The evaluation of comprehensive community-based injury prevention programmes is complex and poses many methodological challenges. There is little consensus in contemporary literature about the most appropriate methods of evaluating these programmes. This study employed a systematic literature review to examine evaluations of 16 community-based injury prevention programmes with regard to key methodological issues and challenges. Three aspects of the evaluated programmes were analysed: assessed elements (context, structure, process, impact, and outcome); study design; and methodological issues addressed. The results showed that context, structure and process assessments were the most neglected aspects of the evaluation studies. The programmes were typically described with minimal discussion of how the context may have influenced the effectiveness. The process (activities) was described rather than evaluated against appropriate standards of comparisons. Impact evaluations adhered more closely to documented guidelines, but half of the evaluations did not include impact variables. Outcome evaluations focused on injury incidence. Most evaluations employed some qualitative methods, but the vast majority of methods used were quantitative. This study indicated that the quasi-experimental study design has become an accepted norm for the evaluation of community-based injury prevention programmes. Most of the evaluations contained explicit details of the methodology used and of the choices related to the methodology. While threats to internal validity were identified in most studies, problems related to external validity and construct validity were largely overlooked by the evaluators.

Community Health Planning↗

PubMed1996

Methodological issues in complementary and alternative medicine research: a personal reflection on 10 years of debate in the United Kingdom.

There are certain immediate and obvious problems in using conventional research techniques for the evaluation of complementary and alternative medicine (CAM). These have led some to argue that alternative medicine requires alternative methodologies. The experience in the United Kingdom has been that existing methodologies can be adapted and do not have to be discarded wholesale. Conventional research has developed a set of powerful techniques for generating reliable knowledge and these have been used with considerable success in a variety of different settings. In retrospect, the call for new methodologies appears to have been a reaction against the perceived dominance of the randomized controlled trial (RCT). This stemmed from the misperception that the RCT inevitably involves features, such as placebo controls or double-blinding, which are not feasible in many CAM therapies. There was also a desire to ask questions about medicine, the answers to which, it was felt, could not be decided by the RCT. A variety of different research designs need to be used to answer the variety of questions important in CAM. However, research designs do not have to be reinvented: appropriate methodologies can normally be found in one or another of the diverse branches of medical research. Successful research has been conducted in CAM using conventional research techniques and this refutes the claims that such techniques are inappropriate for CAM. Solving methodological problems in CAM is a matter of following simple guidelines, not the creation of complex and esoteric research designs.

Complementary Therapies↗

PubMed2006

Methodological quality assessment of review articles evaluating interventions to improve microbial food safety.

Review articles are a means of summarizing the potentially vast volume of research on a topic. However, the methodological quality of review articles varies, and reviews on the same topic may reach different conclusions. We evaluated 65 review articles published between 2000 and 2005 that addressed the effectiveness of microbial food safety interventions, using criteria for methodological soundness developed in the medical field. Overall, the methodological quality of the review articles was poor, with none of the reviews providing information on the method of locating primary research studies or the inclusion/exclusion criteria for selecting primary studies. None of the reviews included a critical appraisal of the methodological quality of the primary studies. Less than half of the reviews stated a focused research question, explored possible reasons for differences in the results of primary studies, discussed the generalizability of results, or proposed directions for future research. There is a need to improve the methodological quality of review articles on microbial food safety interventions if they are to be of use in policy and decision making.

Animals↗

PubMed1997

A review of recently published qualitative research in general practice. More methodological questions than answers?

OBJECTIVE: This study aimed to review published papers which use qualitative interviewing in general practice as their methodology. To look specifically at the detail of how the methodology is presented to the reader, with particular emphasis on the clarity of detail about recruitment, the relationship of the interviewer to the respondents, the setting and how the research was presented to the respondents. METHODS AND RESULTS: A systematic search using Medline and hand searching the British Journal of General Practice, Family Practice and Social Science and Medicine identified 29 recent papers using qualitative interviewing techniques in general practice. The papers were analysed for eight methodological criteria by the author. A second analysis, blind to the results of the first analysis was performed by the author 6 weeks later. An independent assessor analysed 12 randomly selected papers. There was 98.3% intra-assessor agreement and 89.6% inter-assessor agreement about whether the eight criteria were met. Overall 140 of a possible 232 criteria were met (60.3%). CONCLUSION: Published papers using qualitative interviewing in general practice often lack explicit methodological detail about the relationship between the interviewer and the respondents, the setting, who did the recruiting and how the research was explained to the respondents. This methodological detail is important for the critical appraisal of qualitative research, where the context of the research can influence the data.

Family Practice↗

PubMed2001

The methodological quality of randomized controlled trials of homeopathy, herbal medicines and acupuncture.

BACKGROUND: To investigate the methodological quality of randomized controlled trials in three areas of complementary medicine. METHODS: The methodological quality of 207 randomized trials collected for five previously published systematic reviews on homeopathy, herbal medicine (Hypericum for depression, Echinacea for common cold), and acupuncture (for asthma and chronic headache) was assessed using a validated scale (the Jadad scale) and single quality items. RESULTS: While the methodological quality of the trials was highly variable, the majority had important shortcomings in reporting and/or methodology. Major problems in most trials were the description of allocation concealment and the reporting of drop-outs and withdrawals. There were relevant differences in single quality components between the different complementary therapies: For example, acupuncture trials reported adequate allocation concealment less often (6% versus 32% of homeopathy and 26% of herb trials), and trials on herbal extracts had better summary scores (mean score 3.12 versus 2.33 for homeopathy and 2.19 for acupuncture trials). Larger trials published more recently in journals listed in Medline and in English language scored significantly higher than trials not meeting these criteria. CONCLUSION: Trials of complementary therapies often have relevant methodological weaknesses. The type of weaknesses varies considerably across interventions.

Acupuncture Therapy↗

PubMed2000

A systems-based methodology for structural analysis of health care operations.

This paper introduces a systems-based methodology for conducting analysis of organizational structure for health care operations. Increasingly, health care organizations must operate in turbulent environments characterized by rapid change, high levels of uncertainty, and increasing levels of complexity. A fundamental issue for effective-performance in these environments is the development and maintenance of organizational structures that simultaneously provide both operational stability and agile response to environmental turbulence. Drawing from systems science, a systems-based methodology for structural analysis of healthcare operations is developed. This methodology identifies operational deficiencies stemming from inadequate organizational structure and suggests focal areas for structural modification. The results from an application of the methodology in a health care organization are examined. Implications and limitations for use of the methodology by health care professionals are provided.

Efficiency, Organizational↗

PubMed1999

Estimated alcohol consumption in the 1995 National Health Survey: some methodological issues.

OBJECTIVE: This paper critically examines the methodology used to ascertain alcohol consumption in the 1995 Australian Bureau of Statistics National Health Survey (NHS). METHOD: The 1995 NHS was the second in a series of regular, five-yearly population surveys designed to obtain national benchmark information on a range of health-related issues and enable the monitoring of trends over time. The first survey was conducted in 1989-90. In the 1995 NHS, respondents were asked about the quantity of each of seven types of alcohol consumed on up to three days of the week before the interview day. In the 1989-90 NHS, however, respondents were asked about alcohol consumption on each of the seven days before the interview. This paper uses Unit Record Data from the 1989-90 National Health Survey to investigate the methodology used in 1995. RESULTS: It is shown that the estimates of alcohol consumption obtained using the 1995 methodology are highly dependent on the day of the week on which the interviews were conducted. CONCLUSION: It is recommended that the 1995 methodology not be used in future NHS surveys. The 1989-90 methodology of seven-day retrospective diaries would seem a better choice for future National Health Surveys.

Adolescent↗

PubMed2000

Beam-commissioning methodology for a three-dimensional convolution/superposition photon dose algorithm.

Commissioning beam data for the convolution/superposition dose-calculation algorithm used in a commercial three-dimensional radiation treatment planning (3D RTP) system (PINNACLE(3), ADAC Laboratories, Milpitas, CA) can be difficult and time consuming. Sixteen adjustable parameters, as well as spectral weights representing a discrete energy spectrum, must be fit to sets of central-axis depth doses and off-axis profiles for a large number of field sizes. This paper presents the beam-commissioning methodology that we used to generate accurate beam models. The methodology is relatively rapid and provides physically reasonable values for beam parameters. The methodology was initiated by using vendor-provided automodeling software to generate a single set of beam parameters that gives an approximate fit to relative dose distributions for all beams, open and wedged, in a data set. A limited number of beam parameters were adjusted by small amounts to give accurate beam models for four open-beam field sizes and three wedged-beam field sizes. Beam parameters for other field sizes were interpolated and validated against measured beam data. Using this methodology, a complete set of beam parameters for a single energy can be generated and validated in approximately 40 h. The resulting parameter values yielded calculated relative doses that matched measured relative doses in a water phantom to within 0.5-1.0% along the central axis and 2% along off-axis beam profiles for field sizes from 4 cmx4 cm to the largest field size available. While the methodology presented is specific to the ADAC PINNACLE(3) treatment planning system, the approach should apply to other implementations of the dose model in other treatment planning system.

Algorithms↗