Study design: A research primer for low- and middle-income countries
Creator
Graham CA; Simon EL; Knott J
Publisher
African Journal Of Emergency Medicine
Date
2020
1905-07
Description
Study design is critical to ensure that research questions are answered in an appropriate and rational manner for all aspects of health, but particularly in emergency care. Appropriate study design selection is one of the most critical decisions to make at the earliest stage of a research project; once this is clear, much of the methodology and sample size estimations should be straightforward. Selection of an appropriate study design is fundamental to good research and deserves careful consideration at the outset of any research project. The classic gold standard for study design is the double-blind randomised clinical trial, but it is often not possible to achieve this ideal in the busy clinical emergency environment or with the resources available. Descriptive studies are common in emergency care; they include retrospective clinical records reviews, prospective cohort studies and case-control studies. Case reports and surveys can be a useful introduction to research for novice researchers. When sufficient empirical evidence on a topic exists, results of similar studies can be combined in systematic reviews and/or meta-analyses to pool the results from multiple studies to determine stronger evidence for or against an intervention or treatment, but these techniques require specialist expertise and statistical skills.
Subject
Emergency medicine; Research methods; Study design
The After Discharge Care Management of Low Income Frail Elderly (AD-LIFE) Randomized Trial: Theoretical Framework and Study Design.
Creator
Allen Kyle R; Hazelett Susan E; Jarjoura David; Wright Kathy; Fosnight Susan M; Kropp Denise J; Hua Keding; Pfister Eugene W
Publisher
Population Health Management
Date
2011
2011-06
Description
Interdisciplinary care management is advocated for optimal care of patients with many types of chronic illnesses; however, few models exist that have been tested using randomized trials. The purpose of this report is to describe the theoretical basis for the After Discharge Management of Low Income Frail Elderly (AD-LIFE) trial, which is an ongoing 2-group randomized trial (total n = 530) to test a chronic illness management and transitional care intervention. The intervention is based on Wagner's chronic illness care model and involves comprehensive posthospitalization nurse-led interdisciplinary care management for low income frail elders with chronic illnesses, employs evidence-based protocols that were developed using the Assessing Care of Vulnerable Elders (ACOVE) guidelines, emphasizes patient activation, and integrates with community-based long-term care and other community agencies. The primary aim of the AD-LIFE trial is to test a chronic illness management intervention in vulnerable patients who are eligible for Medicare and Medicaid. This model, with its standardized, evidence-based medical and psychosocial intervention protocols, will be easily transportable to other sites interested in optimizing outcomes for chronically ill older adults. If the results of the AD-LIFE trial demonstrate the superiority of the intervention, then this data will be important for health care policy makers. ( Population Health Management 2011;14:137-142)
Subject
Aged; Frail Elderly; Study Design; Conceptual Framework; Health Care Delivery; Transitional Programs; Models; Theoretical; Treatment Outcomes; Multidisciplinary Care Team; Medical Practice; Poverty; 80 and Over; Evidence-Based; Chronic Disease – Therapy; After Care – Methods; Disease Management – Methods; Integrated – Methods; Randomized Controlled Trials – Evaluation
The Promoting Effective Advance Care for Elders (PEACE) Randomized Pilot Study: Theoretical Framework and Study Design.
Creator
Allen Kyle R; Hazelett Susan E; Radwany Steven; Ertle Denise; Fosnight Susan M; Moore Pamela S
Publisher
Population Health Management
Date
2012
2012-04
Description
Practice guidelines are available for hospice and palliative medicine specialists and geriatricians. However, these guidelines do not adequately address the needs of patients who straddle the 2 specialties: homebound chronically ill patients. The purpose of this article is to describe the theoretical basis for the Promoting Effective Advance Care for Elders (PEACE) randomized pilot study. PEACE is an ongoing 2-group randomized pilot study ( n = 80) to test an in-home interdisciplinary care management intervention that combines palliative care approaches to symptom management, psychosocial and emotional support, and advance care planning with geriatric medicine approaches to optimizing function and addressing polypharmacy. The population comprises new enrollees into PASSPORT, Ohio's community-based, long-term care Medicaid waiver program. All PASSPORT enrollees have geriatric/palliative care crossover needs because they are nursing home eligible. The intervention is based on Wagner's Chronic Care Model and includes comprehensive interdisciplinary care management for these low-income frail elders with chronic illnesses, uses evidence-based protocols, emphasizes patient activation, and integrates with community-based long-term care and other community agencies. Our model, with its standardized, evidence-based medical and psychosocial intervention protocols, will transport easily to other sites that are interested in optimizing outcomes for community-based, chronically ill older adults. ( Population Health Management 2012;15:71-77)
Subject
Ohio; Aged; Quality of Life; Health Care Costs; Pilot Studies; Practice Guidelines; Study Design; Conceptual Framework; Collaboration; Palliative Care; Depression; Goal-Setting; Disease Management; Multidisciplinary Care Team; Anxiety; Home Health Care; Chronic Disease – In Old Age – Ohio; Health Promotion – In Old Age – Ohio