NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

Different Kinds of Research

Human beings like to categorize things. We don’t like amorphous groupings of ideas floating around. It just makes things difficult to comprehend. I’m not going to shock anyone when I say that one thing that is divided into categories is research. One way to make research topics more manageable is dividing the topics by asking the question, ‘What will this be used for?’NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

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Applied research is one type of research that is used to answer a specific question that has direct applications to the world. This is the type of research that solves a problem. We will look at an example later.

Basic research is another type of research, and it is driven purely by curiosity and a desire to expand our knowledge. This type of research tends not to be directly applicable to the real world in a direct way, but enhances our understanding of the world around us. So, the real difference between the two types of research is what they will be used for. Will the research be used to help us understand a real world problem and solve it, or will the research further our general information?NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

Applied Research

As mentioned before, applied research is something that we can use. Here is a simple question: ‘How should a student study?’ There are many ways to go about answering this question, and the ones we will look at have a direct and applicable finding. For example, what can research tell us about how a student studies?

Applied Research

Applied research “aims at finding a solution for an immediate problem facing a society, or an industrial/business organization, whereas fundamental research is mainly concerned with generalizations and with the formulation of a theory”[1]. Applied research is considered to be non-systematic inquiry and it is usually launched by a company, agency or an individual in order to address a specific problem.[2]NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

Differences between Applied Research and Fundamental (Basic) Research

The difference between applied and fundamental or basic research is straightforward – findings of applied research can be applied to resolve issues, whereas fundamental studies are used simply to explore certain issues and elements.

Moreover, differences between applied and basic research can be summarized into three points:

1. Differences in purpose. Purpose of applied studies is closely associated with the solution of specific problems, while the purpose of fundamental studies relate to creation of new knowledge or expansion of the current knowledge without any concerns to applicability.

2. Differences in context. In applied studies, research objectives are set by clients or sponsors as a solution to specific problems they are facing. Fundamental studies, on the other hand, are usually self-initiated in order to expand the levels of knowledge in certain areas NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper .

3. Differences in methods. Research validity represents an important point to be addressed in all types of studies. Nevertheless, applied studies are usually more concerned with external validity, whereas internal validity can be specified as the main point of concern for fundamental researchers.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

Examples of Applied Research

The following are examples for applied research. You can notice that each of these studies aim to resolve a specific and an immediate problem.

  • A study into the ways of improving the levels of customer retention for Wall-Mart in China
  • An investigation into the ways of improving employee motivation in Marriot Hotel, Hyde Park
  • Development of strategies to introduce change in Starbucks global supply-chain management with the view on cost reduction NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper
  • A study into the ways of fostering creative deviance among st employees without compromising respect for authority.

Advantages and Disadvantages of Applied Research

The advantages and disadvantages of applied and fundamental research mirror and contrast each other. On the positive side, applied research can be helpful in solving specific problems in business and other settings.

On the negative side, findings of applied research cannot be usually generalized. In other words, applicability of the new knowledge generated as a result of applied research is limited to the research problem. Moreover, applied studies usually have tight deadlines which are not flexible.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

You need to specify the type of your research in the earlier part of the research methodology chapter in about one short paragraph. Also, in this paragraph you will have to justify your choice of research type.

The Research Methodology and Statistical Reasoning Course includes topics ranging from what is a variable to, where can one use a two-way ANOVA. Statistics are widely used in social sciences, business, and daily life. Given the pervasive use of statistics, this course aims to train participants in the rationale underlying the use of statistics. This course aims to explain when to apply which statistical procedure, the concepts that govern these procedures, common errors when using statistics, and how to get the best analysis out of your data.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper Research methodology is used a base to explain statistical reasoning. The course also familiarizes you with commonly used software for statistical analysis. The course will take 11 hours to complete, including one contact hour with the course instructor after completion of the workshop. The course is divided into 11 broad sections, which include 59 lectures and 21 quizzes. Participants would benefit from the course because understanding basic research methodology and statistics is essential prior to taking up any research-related endeavor. It is also an important part of the college curriculum from undergraduate to PhD levels. Designing research methods requires knowledge about various methods and understanding data. The comprehensive nature of the course ensures that students and professionals are not only able to understand, but also apply the course content. The course not only includes course content, but instructors that are approachable after completing it, who will provide feedback and address your specific needs.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

This paper presents a basic methodology for an effective and efficient retrieval and recording of written materials in a subject area. The purpose of the literature review is examined and the criteria for selection of materials for inclusion are outlined. The methodology then describes the role of the librarian, various types of information resources, how to choose appropriate indexing and abstracting services, and a simple efficient method of recording the items found.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper The importance and use of Medical Subject Headings for research in physiotherapy is emphasized. A survey of types of book materials and how to locate them is followed by a detailed description of the most useful indexing and abstracting services available, in particular, the publications of the National Library of Medicine, notably Index Medicus, as well as Excerpt Media and the Science Citation Index. A discussion of on-line search services, their coverage and availability in Canada, concludes the review of information sources. Finally, guidelines for selecting and summarizing the materials located and comments on the literary style for a review are supplied.

The mission of the Research, Measurement, and Evaluation (RME) doctoral program is to provide students with the requisite training in the application of statistical and measurement methodologies to conduct original research in the fields of research and measurement methodology, and to serve as an expert in the areas of research design, data analysis, and measurement.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

Purpose and Goals
The objective of the RME program is to train individuals to become experts in the research methodology, measurement, and applied statistics used in conducting applied research, evaluations, and assessments related to educational, psychological, and health outcomes. Graduates of the program have obtained skills concerning: how to design research studies and evaluations, what statistical and measurement analyses must be conducted to answer the desired research questions, how to analyze the collected data using appropriate statistical software.
An emphasis of the program is on gaining experience in the application of the relevant methodologies using real-world data examples.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

The Ph.D. in RME provides individuals with an in-depth knowledge of intermediate and advanced statistical and measurement methodologies, as well as preparing individuals to make original contributions to the fields of measurement and statistics. Completion of the Ph.D. requires a minimum of 63 graduate semester credit hours, divided between a core set of required courses, a set of elective courses, and dissertation hours. Although students in the Ph.D. program are trained in a broad range of measurement and statistical methodologies, they will conduct focused research in one of two areas of specialization under the tutelage of RME faculty: (a) research methodology and statistics, and (b) measurement. Research methodology and statistics concern how to collect and analyze data to answer desired research questions. Statistical analyses can range from very simple descriptive analyses, to cutting-edge methods using sophisticated statistical models. The field of measurement concerns how we obtain measures of mental, psychological, and cognitive traits (e.g., ability, intelligence, depression). Because many of the traits investigated in education, psychology, and the health sciences are not directly observable the field of measurement makes use of a variety of statistical models to obtain the best possible estimates of an individual’s level on the desired trait based on the responses given to a set of items (i.e., a test, rating scale, or psychological inventory). These techniques are of particular importance to testing agencies that are assessing the ability of examines taking high-stakes tests.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

Clemson’s Department of Public Health Sciences Doctor of Philosophy (PhD) and Master of Science (MS) degrees in Applied Health Research and Evaluation rigorously prepare future scholars to conduct research in population health and healthcare. Students learn to design and employ cutting-edge research methodologies with community, private sector, and public partners to provide effective solutions to challenging health problems.

The curriculum emphasizes a full spectrum of methodological skills that enable students to design and implement research focused on health outcomes, effective and efficient health services delivery, comparative effectiveness of clinical and cost outcomes, and to conduct program evaluation. Students devote substantial attention to implementation science: that bridge between health research and health practice.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

Our interdisciplinary faculty hold terminal degrees in health promotion and behavior, community psychology, epidemiology, health communication, medical sociology, medicine, health services research, health economics, and health policy.

The doctoral program in Applied Health Research and Evaluation is designed to produce innovative, independent leaders in methodology and healthcare research skilled at transcending the traditional barriers between clinical, laboratory, and social science to rigorously test and evaluate clinical and population health data and then translate those findings into practice. Because this program fosters trans disciplinary faculty collaboration and involves research partnerships in communities and healthcare settings in the region, graduates are prepared to initiate and conduct applied research and evaluation that improves a wide variety of health delivery systems. Graduates of this program possess a depth and breadth of knowledge in the determinants of health, healthcare systems, research and evaluation design, epidemiology, and quantitative and qualitative methods, making them valuable assets to academia, large corporations, the health insurance industry, government agencies, health care organizations, and consulting firms.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

Candidates for the PhD degree must complete 66 hours of approved coursework in five years. These credits include 36 hours of core research courses and seminars, 18 hours of dissertation coursework, and 12 hours of content coursework approved by the student’s adviser. Students who enter the program with a master’s degree, may be allowed to exempt a maximum of 12 credits if appropriate courses were completed in their master’s degree program. The faculty determines course exemptions and approves them at the time of admission

The doctoral program in Applied Health Research and Evaluation also awards a master of science degree (en route) for those who complete PhD degree. Students who choose to leave the program before the completion of the PhD must complete 34 credits of core research and seminar coursework, and prepare a publishable paper in order to be awarded the MS in Applied Health Research and Evaluation.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

Students applying to the PhD program are expected to have competitive GRE scores, have completed six credits of statistics or research methods, and have previous research experience.

Deficits in courses completed or foundation skills in statistics require remediation with approved classes taken in addition to the courses outlined in the PhD curriculum below. This curriculum is representative, but flexibility with regard to content and dissertation coursework is expected. Content courses allow students to develop an appropriate content area to enrich their research agenda. These courses could include those in nutrition, physical activity, the build environment, aging, substance abuse, violence, health communication, health care, advanced statistics, qualitative assessment, survey design, or secondary data analysis. Students should consult their advisor.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

This program provides students with a broad understanding of appropriate applications of statistical and research methodology and with experience in using computers effectively for statistical analysis.

The master’s and doctoral programs in Applied Statistics and Research Methods are designed to prepare graduates in statistics and education who make important contributions to educational practice. Through the programs, great emphasis is placed on how research design and statistics can be applied to educational issues and problems. Service courses are offered by the school in support of other university programs at the graduate level.

Admission : Applications must be complete and on file in the ASRM office by March 1 for Fall admission and by October 1 for Spring admission.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

Applied Statistics and Research Methods M.S.

Students planning on concentrating on applied statistics need a working knowledge of calculus and linear algebra. Students must also provide a written statement regarding the relationship of the Master’s program to the student’s professional goals.

Completion of this degree will enable the graduate to seek employment in a career field requiring the application of statistical or research methodology, for example: data analysis or experimental design; to teach in a community or junior college; to work as an evaluation/assessment specialist in a public school setting; or to enter a Ph.D. program in statistics, educational research, or a related area.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

Statistics are vital to nursing. A statistic is basically a way of viewing and understanding data. More specifically, data describes how one event or situation relates to another event or situation. It is also important in knowing what methods are most effective when administering medications or following protocols. Many times when a veteran nurse knows something specific through experience, it is also a form of informal statistics.

Sometimes a nurse may make observations about a patient that may or may not require concern. Statistics allow the nurse to make a judgement on whether or not follow up or further immediate medical attention is required. For example, a triage nurse needs to know what the likelihood of waiting a certain time in an emergency room exacerbating a condition will be in order to make informed decisions about prioritizing treatment. A nurse who has been in practice for many years may know what the priority should be without knowing the formal statistics and percentages involved.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

It is also important in clinical nursing to determine if a commonly used method should be changed or if protocols should be revised. For this example, all of the numbers are random and only used to show the main idea. If the policy in a hospital is to change out an IV line every twenty-four hours, but there is a study that shows that changing the IV line every twenty hours reduced the risk of phlebotomists by 20%, it would be a statistical reason to change procedures.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

Statistics is an integral part of the nursing profession. It has a direct affect on patient care in a variety of settings as well as the potential to change policies and procedures on a wider scale.

A working understanding of the major fundamentals of statistical analysis is required to incorporate the findings of empirical research into nursing practice. The primary focus of this article is to describe common statistical terms, present some common statistical tests, and explain the interpretation of results from inferential statistics in nursing research. An overview of major concepts in statistics, including the distinction between parametric and non parametric statistics, different types of data, and the interpretation of statistical significance, is reviewed.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper Examples of some of the most common statistical techniques used in nursing research, such as the Student independent t test, analysis of variance, and regression, are also discussed. Nursing knowledge based on empirical research plays a fundamental role in the development of evidence-based nursing practice. The ability to interpret and use quantitative findings from nursing research is an essential skill for advanced practice nurses to ensure provision of the best care possible for our patients.

Applied Nursing Research presents original, peer-reviewed research findings clearly and directly for clinical applications in all nursing specialties. Regular features include “Ask the Experts,” research briefs, clinical methods, book reviews, news and announcements, and an editorial section. Applied Nursing Research covers such areas as pain management, patient education, discharge planning, nursing diagnosis, job stress in nursing, nursing influence on length of hospital stay, and nurse/physician collaboration.

Applied Research Methodology in Nursing Care

The master’s degree in Applied Research Methodology in Nursing Care provides the knowledge and skills required to carry out and evaluate quantitative and qualitative research projects on the areas of care, teaching and management in which nurses work.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

The principle objective of the master’s degree is for students to gain essential skills in planning, organizing and evaluating scientific studies on nursing care. The syllabus introduces the scientific method and covers the procedures and techniques used to obtain and analyse data and to communicate and disseminate the results and conclusions of studies. In addition, the course offers a wide range of optional subjects, such as research areas in nursing, information and communication technologies, social and health inequalities, ethics and the gender perspective in research, and evidence-based nursing practice, among others. This master’s degree is intended for holders of nursing degrees and diplomas with some experience of research-related activities.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

Nursing Research: Definitions and Directions

In order to provide further insight into the need for, philosophy, and scope of nursing research this appendix presents a position statement issued by the Commission on Nursing Research of the American Nurses’ Association. It is quoted here in its entirety:1

Recent years have seen a growing awareness among the public that valuable resources are finite and their use must be carefully considered. In this context, increasing attention is being given to the relative cost of various strategies for utilizing health care resources to meet the present and emerging needs of the nation. Concurrently, nurses are assuming increased decision-making responsibility for the delivery of health care, and they can be expected to continue to assume greater responsibility in the future. Therefore, the timeliness and desirability of identifying directions for nursing research that should receive priority in funding and effort in the 1980s is apparent.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

The priorities identified below were developed by the Commission on Nursing Research of the American Nurses’ Association, a nine-member group of nurses actively engaged in research whose backgrounds represent considerable diversity in preparation and experience. The priorities represent the consensus of the commissioners, developed through a process of thoughtful discussion and careful deliberation with colleagues.

Accountability to the public for the humane use of knowledge in providing effective and high quality services is the hallmark of a profession. Thus, the preeminent goal of scientific inquiry by nurses is the ongoing development of knowledge for use in the practice of nursing; priorities are stated in that context. Other guiding considerations were the present and anticipated health problems of the population; a historic appreciation of the circumstances in which nursing action has been most beneficial; nursing’s philosophical orientation, in which emphasis is on a synthesis of psycho social and biomedical phenomena to the end of promoting health and effective functioning; and projections regarding the types of decisions nurses will be making in the last decades of the twentieth century. NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper  New, unanticipated problems will undoubtedly confront the health care resources of the country; yet it is clear that many of the problems of the future are already manifest today. New knowledge is essential to bring about effective solutions. Nursing research directed to clinical needs can contribute in a significant way to development of those solutions.

Definition of Nursing Research

Nursing research develops knowledge about health and the promotion of health over the full lifespan, care of persons with health problems and disabilities, and nursing actions to enhance the ability of individuals to respond effectively to actual or potential health problems.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

These foci of nursing research complement those of biomedical research, which is primarily concerned with causes and treatments of disease. Advancements in biomedical research have resulted in increased life expediencies, including life expediencies of those with serious injury and those with chronic or terminal disease. These biomedical advances have thus led to growth in the numbers of those who require nursing care to live with health problems, such as the frail elderly, the chronically ill, and the terminally ill.

Research conducted by nurses includes various types of studies in order to derive clinical interventions to assist those who require nursing care. The complexity of nursing research and its broad scope often require scientific underpinning from several disciplines. Hence, nursing research cuts across traditional research lines, and draws its methods from several fields.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

Directions for Research

Priority should be given to nursing research that would generate knowledge to guide practice in:

1.Promoting health, well-being, and competency for personal care among all age groups;
2.Preventing health problems throughout the life span that have the potential to reduce productivity and satisfaction;
3.Decreasing the negative impact of health problems on coping abilities, productivity, and life satisfaction of individuals and families;
4.Ensuring that the care needs of particularly vulnerable groups are met through appropriate strategies;
5.Designing and developing health care systems that are cost-effective in meeting the nursing needs of the population.

Nursing research is research that provides evidence used to support nursing practices. Nursing, as an evidence-based area of practice, has been developing since the time of Florence Nightingale to the present day, where many nurses now work as researchers based in universities as well as in the health care setting.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

Nurse education places focus upon the use of evidence from research in order to rationalise nursing interventions. In England and Wales, courts may determine if a nurse acted reasonably based upon whether their intervention was supported by research.

Nursing research falls largely into two areas:

  • Quantitative research is based in the paradigm of logical positivism and is focused upon outcomes for clients that are measurable, generally using statistics. The dominant research method is the randomized controlled trial.
  • Qualitative research is based in the paradigm of phenomenology, grounded theory, ethnography and others, and examines the experience of those receiving or delivering the nursing care, focusing, in particular, on the meaning that it holds for the individual. The research methods most commonly used are interviews, case studies, focus groups and ethnography NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

Clinical Research Methodology 3: Randomized Controlled Trials

Randomized assignment of treatment excludes reverse causation and selection bias and, in sufficiently large studies, effectively prevents confounding. Well-implemented blinding prevents measurement bias. Studies that include these protections are called randomized, blinded clinical trials and, when conducted with sufficient numbers of patients, provide the most valid results. Although conceptually straightforward, design of clinical trials requires thoughtful trade-offs among competing approaches—all of which influence the number of patients required, enrollment time, internal and external validity, ability to evaluate interactions among treatments, and cost.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

Observational study designs, as explained in our previous 2 reviews, are inherently vulnerable to systematic errors from selection and measurement biases and confounding; retrospective studies may additionally be subject to reverse causation when the timing of exposure and outcome cannot be precisely determined. Fortunately, 2 study design strategies, randomization and blinding, preclude or mitigate these major sources of error.

Randomized clinical trials (RCTs) are cohort studies—necessarily prospective—in which treatments are allocated randomly to the subjects who agree to participate. In the most rigorous randomized trials, called blinded or masked, knowledge of which treatment each patient receives is concealed from the patients and, when possible, from investigators who evaluate their progress. Blinded RCTs are particularly robust because randomization essentially eliminates the threats of reverse causation and selection bias to study validity, and, considerably mitigates the threat of confounding. Well-executed blinding/masking simultaneously mitigates measurement bias and placebo effects by equalizing their impacts across treatments.1 We now discuss these benefits in more detail.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

In reviewing patient records, we would not expect 2 treatments for a medical condition to be randomly distributed among patients because care decisions are influenced by numerous factors, including physician and patient preference. Patients given different treatments may therefore differ systematically and substantially in their risks of outcomes.

Randomization eliminates selection bias in treatment comparisons because, by definition, randomized assignments are indifferent to patient characteristics of any sort. For example, investigators reviewing records might find that aggressively treated septic critical care patients do better than those treated conservatively. Improved outcomes might occur because aggressive therapy was more effective. But it might equally well be that patients who appeared stronger were selected for more aggressive therapy because they were thought better able to tolerate it and then did better because they were indeed stronger. Looking back, it is hard to distinguish selection bias from true treatment effect.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

The threat of confounding, which can be latent in a population or result from selection or measurement bias, refers to attribution error because of a third-factor linking treatment and outcome. For example, anesthesiologists may prefer to use neuralgia anesthesia in older patients under the impression that it is safer. Let us say, however, that younger patients in a study cohort actually do better. But did they do better because of they were given general anesthesia (a causal effect of treatment) or simply because they were younger (confounding by age, the third variable)? Looking back in time, as in a retrospective analysis of existing data, in complex medical situations, it is difficult to determine the extent to which even known mechanisms contribute causally to outcome differences. And it is essentially impossible to evaluate the potential contributions of unknown mechanisms.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

Confounding can only occur when a third factor, the con founder, differs notably between treatment groups in the study sample. Randomization largely prevents confounding because, in a sufficiently large study, patients assigned to each treatment group will most likely be very similar with respect to non–treatment-related factors that might influence the outcome. The tendency of randomization to equalize allocations across treatment groups improves as sample size increases and applies to both known and unknown factors, thus making randomization an exceptionally powerful tool.

Randomized groups in a sufficiently large trial will thus differ substantively only in treatment. The consequence is that, unless there is measurement bias, differences in outcome can be causally and specifically attributed to the treatment itself—which is what we really want to know.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

Trials need to be larger than one might expect to provide a reasonable expectation that routine baseline factors are comparably distributed in each treatment group (i.e., n > 100 per group). For factors that are uncommon, many more patients are required. For example, consider a feasibility trial testing tight-versus-routine preoperative glucose control with 25 patients per group. It is unlikely that average age or weight will differ greatly between the 2 groups. But it would not be too surprising if, by bad luck, 1 group had 14 diabetic patients and the other had just 7. Such a large disparity will occur about 1 in 12 trials of this size, just by chance. But diabetes mellifluous obviously has substantial potential to influence the investigators’ ability to tightly control glucose concentration. Baseline in homogeneity, that is, the disparate numbers of patients with diabetes mellifluous, would then complicate interpretation of the results of an otherwise excellent trial.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

One approach to avoiding baseline heterogeneity is increasing the sample size. Larger sample size lowers the risk of any given level of heterogeneity across all potentially important factors, including unknown con founders. But when there are a limited number of obviously important uncommon factors, an alternative is to stratify randomization (i.e., randomize separately in groups distinguished by the values of these factors), using one of several possible devices that restrict the results so that each factor is distributed roughly evenly across treatment groups. This process assures that even uncommon characteristics, if included in the stratification, will be roughly comparably distributed across treatment groups.

With electronic randomization systems, such as those accessed in real time via the Web, it is possible to include various levels of stratification without difficulty. In multi center studies, permuted-block randomization is virtually always used because site-related variations are assumed to be a substantial potential con founder and a given site may not enroll enough patients to assure baseline homogeneity.NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper In this process, random treatments are assigned in small sequential blocks of each site’s patients, so that different sites’ patients are comparably distributed across treatment groups at the end of each block. Block sizes are concealed from clinicians enrolling patients, and often changed, so that enrolling clinicians and other investigators are masked to the allocation process and cannot know the next patient’s treatment assignment.

Although theoretically straightforward, randomization can be tricky in practice. For example, patients may agree to participate in a randomized trial but then drop out if they are not assigned to the novel treatment they wanted. Similarly, consented patients may remove themselves from a study based on perceived lack of benefit or complications. To the extent that patients drop out of studies non randomly, there remains potential for selection bias.

Outcomes Research

Outcomes research seeks to understand the end results of particular health care practices and interventions. End results include effects that people experience and care about, such as change in the ability to function. In particular, for individuals with chronic conditions—where cure is not always possible—end results include quality of life as well as mortality. NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper By linking the care people get to the outcomes they experience, outcomes research has become the key to developing better ways to monitor and improve the quality of care. Supporting improvements in health outcomes is a strategic goal of the Agency for Healthcare Research and Quality. Outcomes research has altered the culture of clinical practice and health care research by changing how we assess the end results of health care services. In doing so, it has provided the foundation for measuring the quality of care. The results of AHRQ outcomes research are becoming part of the “report cards” that purchasers and consumers can use to assess the quality of care in health plans. For public programs such as Medicaid and Medicare, outcomes research provides policymakers with the tools to monitor and improve quality both in traditional settings and under managed care. Outcomes research is the key to knowing not only what quality of care we can achieve, but how we can achieve it. Several faculty members in Hopkins GIM are internationally recognized experts in outcomes research.  NURS 5501 – Introduction to Statistics and Applied Research Methods Research Paper

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