Tag Archives: research methods

Pilot sTUdies: Look before you leap! (a priori vs. posthoc)

Why does it matter if a study is labeled a “pilot”?

SHORT ANSWER: …Because a pilot is about testing research methods,….not about answering research questions.

If a project has “pilot” in the title, then you as a reader should expect a study that examines whether certain research methods work (methodologic research). Methods include things like timing of data collection, sampling strategies, length of questionnaire, and so on. Pilots suggest what methods will effectively to answer researchers’ questions. Advance prep in methods makes for a smooth research landing.

Small sample = Pilot? A PILOT is related to study goals and design–not sample size. Of course pilots typically have small samples, but a small sample does not a pilot study make. Sometimes journals may tempt a researcher to call their study a pilot because of small samples. Don’t go there. Doing so means after-the-fact, posthoc changes that were Not the original, a priori goals and design.

Practical problems? If researchers label a study a “pilot” after it is completed (post hoc), they raise practical & ethical issues. At a practical level, researchers must create feasibility questions & answers. (See NIH.) The authors should drop data analysis that answers their original research questions.

Ethics? This ethically requires researchers 1) to say they planned something that they didn’t or 2) to take additional action. Additional action may be complete transparency about the change and seeking modification to original human subjects’ committee approvals. An example of one human subjects issue is that you informed your subjects that their data would answer a particular research question, and now you want to use their data to answer something else–methods questions!

Options? You can just learn from your small study and go for a bigger one, including improving methods. Some journals will consider publication of innovative studies even when small.

Look first, then leap: Better to look a priori, before leaping. If you think you might have trouble with your methods, design a pilot. If you made the unpleasant discovery that your methods didn’t work as you hoped, you can 1) disseminate your results anyway or 2) rethink ethical and practical issues.

Who’s with me? The National Institutes of Health agree: https://nccih.nih.gov/grants/whatnccihfunds/pilot_studies . NIH notes that common misuses of “pilots” are determining safety, efficacy of intervention, and effect size.

Who disagrees? McGrath argues that clinical pilots MAY test safety and efficacy, as well as feasibility. (See McGrath, J. M. (2013). Not all studies with small samples are pilot studies, Journal of Perinatal & Neonatal Nursing, 27(4): 281-283. doi: 10.1097/01.JPN.0000437186.01731.bc )

Trial Balloons & Pilot Studies

A pilot study is to research what a trial balloon is to politics

In politics, a trial balloon is communicating a law or policy idea via media to see how the intended audience reacts to it.  A trial balloon does not answer the question, “Would this policy (or law) work?” Instead a trial balloon answers questions like “Which people hate the idea of the policy/law–even if it would work?” or “What problems might enacting it create?” In other words, a trial balloon answers questions that a politician wants to know BEFORE implementing a policy so that the policy or law can be tweaked to be successfully put in place.

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In research, a pilot study is sort of like a trial balloon. It is “a small-scale test of the methods and procedures” of a planned full-scale study (Porta, Dictionary of Epidemiology, 5th edition, 2008). A pilot study answers questions that we want to know BEFORE doing a larger study, so that we can tweak the study plan and have a successful full-scale research project. A pilot study does NOT answer research questions or hypotheses, such as “Does this intervention work?”  Instead a pilot study answers the question “Are these research procedures workable?”

A pilot study asks & answers:Can I recruit my target population? Can the treatments be delivered per protocol? Are study conditions acceptable to participants?” and so on.   A pilot study should have specific measurable benchmarks for feasibility testing. For example if the pilot is finding out whether subjects will adhere to the study, then adherence might be defined as  “70 percent of participants in each [group] will attend at least 8 of 12 scheduled group sessions.”  Sample size is based on practical criteria such as  budget, participant flow, and the number needed to answer feasibility questions (ie. questions about whether the study is workable).

A pilot study does NOT Test hypotheses (even preliminarily); Use inferential statistics; Assess safety of a treatment; Estimate effect size; Demonstrate safety of an intervention.

A pilot study is not just a small study.

Next blog: Why this matters!!

For more info read the source of all quotes in this blog: Pilot Studies: Common Uses and Misuses @ https://nccih.nih.gov/grants/whatnccihfunds/pilot_studies

After taste…I mean “after test”

Let’s say you want to find out how well students’ think they learned theory in your class.

One option is to do a pre/post test: You distribute the same survey before and after the class asking them to rate on 1-4 scale how well they think they know the new material. Then you compare their ratings.

Another option is to do posttest only: You could give them a survey after the class that Surveyasks them to rate 1-4 their knowledge before the class and 1-4 their knowledge now. Then you compare their ratings.

One research option is stronger than the other.  Which one is it? and Why?  (hint: think retrospective/prospective)

2019: It is…….

I’m not a New Year’s resolution person.  I used to be and then I realized that I wanted to hit the restart button more often than every 365 days.  So…my aim for this blog remains pretty much unchanged:   Make research processes and ideas understandable for every RN.

DifficultToBeSimpleAlthough “to be simple is difficult,” that’s my goalLjourneyet me know what’s difficult for you in research, because it probably is for others as well.  Let’s work on the difficult together so that you can use the BEST Evidence in your practice.

The 2019 journey begins today, and tomorrow, and the tomorrows after that!

FOR MORE: Go to PubMed. Search for a topic of interest. Send me the article & we’ll critique together.

Dispelling the nice or naughty myth: retrospective observational study of Santa Claus.

Naughty NiceGo to full article

Abstract

“OBJECTIVE:  To determine which factors influence whether Santa Claus will visit children in hospital on Christmas Day.

DESIGN:  Retrospective observational study.

SETTING:  Paediatric wards in England, Northern Ireland, Scotland, and Wales.

PARTICIPANTS:  186 members of staff who worked on the paediatric wards (n=186) during Christmas 2015.

MAIN OUTCOME MEASURES:  Presence or absence of Santa Claus on the paediatric ward GIFTSduring Christmas 2015. This was correlated with rates of absenteeism from primary school, conviction rates in young people (aged 10-17 years), distance from hospital to North Pole (closest city or town to the hospital in kilometres, as the reindeer flies), and contextual socioeconomic deprivation (index of multiple deprivation).

RESULTS:  Santa Claus visited most of the paediatric wards in all four countries: 89% in England, 100% in Northern Ireland, 93% in Scotland, and 92% in Wales. The odds of him not visiting, however, were significantly higher for paediatric wards in areas of higher socioeconomic deprivation in England (odds ratio 1.31 (95% confidence interval 1.04 to 1.71) in England, 1.23 (1.00 to 1.54) in the UK). In contrast, there was no correlation with school absenteeism, conviction rates, or distance to the North Pole.

CONCLUSION:  The results of this study dispel the traditional belief that Santa Claus rewards children based on how nice or naughty they have been in the previous year. Santa Claus is less likely to visit children in hospitals in the most deprived areas. Potential solutions include a review of Santa’s contract or employment of local Santas in poorly represented region.”  Park et al. (2016).BMJ. 2016 Dec 14;355:i6355. doi: 10.1136/bmj.i6355.

How would you translate this into practice?   Questions to help you with this endeavor:   Where does this retrospective, observational research fall on the evidence hierarchyEBNIs it quantitative or qualitative research?  Experimental or non-experimental research? How generalizable is this research? What are the risks,resources, and readiness of people in potentially using the findings (Stetler & Marram, 1996; Stetler, 2001)?   What might happen if you try to apply the abstract information to practice without reading the full article?  Do you think the project done in Europe is readily applicable to America?  What would be the next level of research that you might undertake to better confirm these findings?
Enjoy your holiday season! -Dr H

“Please answer….” (cont.)

What do people HATE about online surveys?   If you want to improve your response rates, check out SurveyMonkey Eric V’s (May Mail2017)  Eliminate survey fatigue: Fix 3 things your respondents hate 

For more info: Check out my earlier post “Please Answer!”

“Please answer!” – How to increase the odds in your favor when it comes to questionnaires

Self-report by participants is one of the most common ways that researchers collect data, yet it is fraught with problems.   Some worries for researchers are: “Will participants be honest or will they say what they think I want to hear?”   “Will they understand the DifferentGroupsquestions correctly?”  “Will those who respond (as opposed to those who don’t respond) have unique ways of thinking so that my respondents do not represent everyone well?” and a BIG worry “Will they even fill out and return the questionnaire?”

One way to solve at least the latter 2 problems is to increase the response rate, and Edwards et al (2009 July 8) reviewed randomized trials  to learn how to do just that!!Questionnaire faces

If you want to improve your questionnaire response rates, check it out!  Here is Edwards et al.’s plain language summary as published in Cochrane Database of Systematic Reviews, where you can read the entire report.

Methods to increase response to postal and electronic questionnaires

MailPostal and electronic questionnaires are a relatively inexpensive way to collect information from people for research purposes. If people do not reply (so called ‘non-responders’), the research results will tend to be less accurate. This systematic review found several ways to increase response. People can be contacted before they are sent a postal questionnaire. Postal questionnaires can be sent by first class post or recorded delivery, and a stamped-return envelope can be provided. Questionnaires, letters and e-mails can be made more personal, and preferably kept short. Incentives can be offered, for example, a small amount of money with Remember jpga postal questionnaire. One or more reminders can be sent with a copy of the questionnaire to people who do not reply.

 

Critical/reflective thinking:  Imagine that you were asked to participate in a survey.  Which of these strategies do you think would motivate or remind you to respond and why?

For more info read the full report: Methods to increase response to postal and electronic questionnaires

 

Making research accessible to RNs

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