Scholarship

Question 1

What is the hierarchy?

Answer 1

Question 2

What are the different types of bias?

Answer 2

Recall bias– errors due to differences in accuracy/completeness of recall of memoryof past events/experiences

Information bias–collection, recording or handling**of data lead to bias

Attrition bias–unequal loss**of participants from study groups

Hawthorne effect– participantsalter their behaviour**in response to being observed

Confounding– suggests an association wherenone existormasks a true association

Question 3

What is a hazard ratio?

Answer 3

Question 4

Type 1 vs 2 error

Answer 4

• Type I Error (false positive)
• Type II Error (false negative)

Question 5

What are effect sizes?

Answer 5

• Allows us to draw meta-analytic conclusions- multiple effect sizes allow us to best guess the true size of an effect in a population
• Allows power analysis- The number of participants required to achieve a certain probability of finding a true effect

Question 6

What are confidence intervals?

Answer 6

Confidence Interval is a statement about future Confidence Intervals
▹ Says nothing about future sample estimates
▹ Calculates a lower bound and an upper bound around one sample statistic

informs us about the uncertainty of a sample statistic

Question 7

What are the different research designs?

Answer 7

▹ Descriptive- Case study, naturalistic observation, cannot statistically infer unless we have the entire population
▹ Correlational- Case control, observation, considers relationship between two variables free from manipulation, cannot determine cause and effect, third variable problem, spurious correlations, analysis - Pearson, Spearman, point biserial
▹ Experimental- Researchers manipulate a variable, RCTs, control and experimental groups, pre and post event, between two groups or same group pre/post, simple test of difference i.e. t test, compares similarity of two sample estimates i.e. means, more than two groups/conditions, ANOVAs
▹ Review- Literature review (Overview of previously published works, generally descriptive), Systematic review (similar but with detailed and
comprehensive plan/search strategy)
▹ Meta-analytic- Analysis that combines findings of multiple
studies, contrast results across studies, provide better estimate of the unknown population effect size

Question 8

What are the types of NICE appraisals?

Answer 8

• Single technology appraisal (STA) - covers a single technology for a single indication
  
  • Cost comparison - aims to provide quicker access for patients to the most cost effective new treatments.
  • Multiple technology appraisal (MTA) - covers more than one technology, or one technology for more than one indication

Question 9

What are the stages of NICE appraisal

Answer 9

Question 10

QALYs=

Answer 10

Quality of Life (QoL) x time

Question 11

What are the 5 dimensions of QoL

Answer 11

1. Pain/discomfort
2. Usual activities
3. Mobility
4. Anxiety/depression
5. Self care

Question 12

What is ICER?

Answer 12

Question 13

What are the main types of economic evaluation?

Answer 13

Cost-effectiveness analysis (CEA)

• One of the main techniques used
• Outcomes in most appropriate natural or physical units
• Decision rule: dominance (less costly, better outcomes) or cost-effectiveness ratio
• Results in terms of cost per unit effect E.g. lives saved/ complications avoided/ symptom free days/ cancers detected

Cost-utility analysis (CUA)

• Outcomes measured in QALYs
• Combine life years and quality of life
• Can be used to compare across treatment areas
• Decision rule: dominance (less costly, better outcomes) or cost-utility ratio
• Results in terms of cost per additional QALY gained
• Required by decision makers (e.g. NICE)

Question 14

Horizontal vs vertical equity?

Answer 14

1. Horizontal equity
   •People with equal health needs receive equal access to treatment irrespective of demographics
   •Factors/barriers e.g. geography, waiting times, patient information
2. Vertical equity
   •Individuals with unequal needs should be treated according to their differential need
   •Obvious but operationally difficult
   •How unequal do conditions need to be in order to pursue equity objectives (chronic versus trivial complaints)?

Question 15

What are the characteristics of qualitative research?

Answer 15

• Aims to understand the meanings people have constructed about their world and their experiences - how do people make sense of their experiences
• Researchers immerse themselves in the natural setting of the people whose thoughts and feelings they wish to explore.
• Understanding is the aim in itself (rather than predicting).
• The researcher is the primary instrument for data collection and analysis.
• Researchers gather data to build concepts, hypotheses and theories rather than to test them.
• The product is richly descriptive and interpretive - describing context and participants involved.
• Assumption is that the researcher cannot stay detached but needs to be engaged in a personal and subjective process of mutual discovery with the informants.
• What matters is NOT neutrality or validity but IS credibility: other researchers and those researched should be content with the interpretations and findings.

Question 16

Ontology vs epistemology

Answer 16

Ontology- The nature of being (the question)

• DOES IT EXIST? WHAT IS IT?
• Different philosophical positions on reality
• Positivists believe that there is a single reality, which can be measured and known.
• Reality is something tangible that can be objectively measured with the help of observational and experimental methods.
• Qualitative researchers question the assumptions of the positivist paradigm and believe that there is no single reality or truth, and therefore reality needs to be interpreted. Reality is in the eye of the beholder. Constructivism suggests a critical reflection on our truths

Epistemology- The study of knowledge (how we answer the question)

• Epistemology is the branch of philosophy which deals with the theory of knowledge, the way of obtaining valid knowledge. It is concerned with how we use our reason and/or experience to understand and know things.
• How do you know something?
• E.g, how Eastern and Western medicine have developed their bodies of knowledgeis very different. Western medicine uses use scientific reasoning and approaches to determine what diseases are and how to treat them.
• Epistemology questions things like reason vs. experience (and intuitive experience) and how people can agree on various types of knowledge.
• Can reason function independently from experience? How do we know that we know

Question 17

How is qualitative data collected?

Answer 17

• Interviews- structured or unstructured, open or closed questions
• Focus groups- group interview
• Life grids
• Diaries
• Photographs
• Objects
• Scrap books

Question 18

How is qualitative data analysed?

Answer 18

• Thematic analysis- summarise categories
• Phenomenological analysis
• Narrative analysis- explore lives
• Grounded theory approach (Charmaz, 2006)
• Affective textual analysis

Question 19

Quantitative vs quantitative

Answer 19

Question 20

What are 4 aspects of trustworthiness?

Answer 20

• Credibility or the confidence in the truth of the study and therefore the findings, is the most important criterion. Comparable to internal validity in quantitative research. –member check, prolonged engagement
• Dependability the stability of the data over time and over the conditions of the study. Consistent and repeatable. It is similar to reliability in quantitative research, but with the understanding stability of conditions depends on the nature of the study.
• Transferability the extent to which findings are useful to persons in other settings, is different from other aspects of research.
• Confirmability the degree findings could be corroborated. This is similar to objectivity in quantitative research in that it details of audit trail, memos, reflective logs are kept to discuss bias