Research Methods in Health Science - Essay Example

? Research Methods in Heath Science Introduction Philosophy is a means of the world’s cognition. Every aspect of human life or activity can be cognized and interpreted by means of philosophical considerations. Every field of science has a strong philosophical background and in order to cognize the science better, it is relevant to refer to philosophical considerations. A wide scope of facts studied by the science should be considered in a broad context. Therefore, "science deals with objective facts, not with subjective values" (Armstrong, 1968 cited from Study Guide). This is a well-known science-values dichotomy. A scientific discovery should be always considered in relation to the methods implemented in order to overcome methodological and interpretative disputes. Ethical principles used in the scientific researches, different approaches to the issues of reality, truth and knowledge and many other aspects of researches would be easily interpreted from the perspective of philosophical considerations (Patterson, 2000; Scanlan, 1986). The main challenge in discussion about research methods applied in health science researches is differentiation between quantitative and qualitative research methodologies (Grinnell & Unrau, 2005). It is a wrong claim that quantitative researches are based on empirical data collection and qualitative researches are based on subjective approach implementation. Nevertheless, this supposition is wrong, because empirical data collection is relevant to both quantitative and qualitative researchers. The main distinction between these two methodologies lies in the following terms: quantitative research methodologies imply inductive inference and qualitative researches are focused more on a research question. Philosophical considerations in the research The article by Janardhana, Rajagopal, Rao, Kamath “Correlation between clinical features and magnetic resonance imaging findings in lumbar disc prolapse” (2010) is an example of quantitative research. The following discussion about research methods implied in health science on the basis of the chosen article is focused on philosophical framework of the article. The research question considered by the authors is focused on correlation “the abnormalities observed on MRI and clinical features of lumbar disc prolapse” (Janardhana, Rao & Kamath, 2010). The main goal of the authors was to consider “a correlation between clinical features and MRI findings in lumbar disc prolapse in order to define the significance of further treatment development” (Janardhana, Rao & Kamath, 2010). The main clinical features studied among patients were the following: pain distribution, neurological signs, and symptoms in lumbar disc prolapse (Janardhana, Rao & Kamath, 2010). Therefore, the authors were focused on patients’ clinical features, such as lower limb radiculopathy and the outpatient department of orthopedics were included in the study. The authors chose quantitative approach to the current health study. This fact can be proven by the fact that a focus group consisted of 119 patients, 59 males and 64 females. The mean age (44.83 years) of patients and a range of female/male age groups indicated in the results section of the study refers to the main features of quantitative research (Moore, 2008). Moreover, in the section of “Materials and Methods” it was noted that Kappa coefficient was implemented for assessment of intra- and interobserver variations. Furthermore, implementation of statistical tests (Kappa and Logistic regression analysis) confirms the nature of quantitative research. A correlation between research question and a chosen approach It is relevant to notice that in previous studies in this field, MRI findings were rarely correlated with clinical level and MRI level. A high percentage of cases when the L4-5 disc prolapse was not only responsible for L5 radiculopathy in 67 (94.36%) cases imply that there is a “good correlation between the clinical level and MRI level” (Janardhana, Rao & Kamath, 2010). Moreover, a high level of L5-S1 radiculopathy responsible for S1 radiculopathy in 39 (81.25%) cases and L5 radiculopathy in 14 (29.16%) cases. The authors underline a finding of efficient correlation between “the clinical level and MRI may not be essential for clinical diagnosis, MRI is definitely essential when surgery is planned” (Janardhana, Rao & Kamath, 2010). It is underlined in the study that there is a need to assess a level of neural foramen compromising and occurrence of nerve root compression. These facts are relevant for surgical options considerations. Research sample The main six sections of quantitative research are the following: correlation and prediction; issues of sampling; hypothesis testing; parametric statistical tests; non-parametric statistical tests; interpretation, power, sample size, and introduction to multivariate techniques (Study Guide). The authors of this article show basic mathematical skills (addition, multiplication etc). Moreover, authors show their awareness of statistics knowledge and operation of statistics interpretation skills. The nature of errors occurred in the process of research performance is also underlined by the authors. Tables were used by the authors as descriptive tools. MRI findings were assessed in accordance with inter- and intraobserver variability. A correlation of MRI findings with clinical symptoms and the level of disc prolapse as well as neurological signs and symptoms were presented with implementation of statistical analysis applying the Kappa coefficient, Odd«SQ»s ratio, and logistic regression analysis (Munro, 2001). Erroneous nature of Kappa coefficient implementation was underlined by the authors, because no significant inter- or intraobserver variations for most of MRI findings were found. An interobserver variation of 0.46 (Kappa value) was assessed only with regard to type of disc herniation. The strongest correlation was fixed between “centrolateral protrusions and extrusions with neural foramen compromise with the dermatomal distribution of pain” (Janardhana, Rao & Kamath, 2010). Validity and reliability of obtained results It should be noted that the relevance of this study can be supported by the fact that researches focused on lumbar disc prolapse did not provide correlation between clinical findings and MRI findings. The study conducted by Rankine et al. (Janardhana, Rao & Kamath, 2010) can be considered as a relative study to the study considered. The former authors claimed that “pain drawing is not a good predictor of nerve compression on MRI with a poor correlation” (Janardhana, Rao & Kamath, 2010). Borenstein and others considered that it is useless to study correlation between MRI findings and that clinical correlation is essential. Nevertheless, the study conducted was based on involvement of asymptomatic participants.  The researchers claim that in case disc prolapse correlates with the clinical level and the role of MRI may be diminished for clinical diagnosis, its importance cannot be denied in the process of surgery planning (Borsboom, & Mellenbergh, 2004). Nevertheless, the authors agree upon the fact that MRI test is very sensitive and not specific at all. Moreover, MRI findings influencing on symptoms diagnostics are essential for “neural foramen compromise and nerve root compression” (Janardhana, Rao & Kamath, 2010). The position of disc herniation can affect the neural foramen compromise as central protrusion and extrusions are less likely to cause neural foramen compromise while centrolateral or far lateral lesions in all cases produced neural foramen compromise. Another finding is that unlike previous studies, a current study underlines that “the percentage of patients with disc extrusion having foramen compromise or root compression is higher compared to those with a disc bulge producing foramen compromise, a pure central disc extrusion or protrusion is asymptomatic in most cases” (Janardhana, Rao & Kamath, 2010). For surgical options such findings of the study are relevant as well; these are the following: a centrolateral disc extrusion, centrolateral disc protrusion, and disc bulge with neural foramen compromise cause symptoms and central disc protrusions and extrusions together with disc bulges without foramen compromise do not produce symptoms to such an extent.  Therefore, validity and reliability of the research is evident though it attempts to cover those issues, which have not been properly studied by other scientists and researchers. Analysis techniques A sampling method chosen by the authors of the article is appropriate for quantitative research method. Nevertheless, a number of patients’ involved (119 participants) should be adjusted to 120. In such a way, it would be easier for them to make their calculations, to facilitate performance of statistical analysis applying the Kappa coefficient, Odd«SQ»s ratio, and logistic regression analysis. The relative merits of the chosen sampling methods are in comparatively equal number of males and females involved and presence of asymptomatic patients. It should be noted, that authors could benefit from applying synthesizing approaches and research methods. With this respect, it is relevant to apply “Triangulation” method (Dootson, 1995). This method is popular in a modern health science, because it allows researchers not only to collect and analyze data, but also synthesize quantitative and qualitative research methods (Newman & Benz, 1998). In the current researcher the authors could synthesize various sources of data in order to interpret a phenomenon of lumbarc disc prolapse from a broader perspective. With this respect, a level of credibility to the research would increase. A partial application of triangulation method can be proven by the authors’ usage of different theories and presentation of a theoretical framework in the “Discussion” section. Therefore, the author applied “theory triangulation”. Moreover, they applied 3 different kinds of statistical analysis, such as the Kappa coefficient, Odd «SQ»s ratio, and logistic regression analysis. Thus, it can be concluded that the authors used “method triangulation” in order to examine the issue to be studied with the help of different methods. Therefore, a principle of triangulation if applied for the current research would be the following: synthesis of qualitative and quantitative data with regard to data collected and processed, as well as data analyzed in previous researchers (Sim & Wright, 2000). Another advantage of a principle of triangulation application would be analysis of various data sources with involvement of experts in this area. In this case, reliability and validity of reached results could facilitate dissemination of data obtained and it would serve as a great contribution to the researches of health science in the field of lumbar disc prolapse studying. Conclusion Every aspect of human life or activity can be cognized and interpreted by means of philosophical considerations. Every field of science has a strong philosophical background and in order to cognize the science better, it is relevant to refer to philosophical considerations. Ethical principles used in the scientific researches, different approaches to the issues of reality, truth and knowledge and many other aspects of researches would be easily interpreted from the perspective of philosophical considerations. Therefore, a principle of triangulation if applied for the current research would be the following: synthesis of qualitative and quantitative data with regard to data collected and processed, as well as data analyzed in previous researchers. In such a way, we can claim that contribution of the research to the field of research conduct follows methodological principles of quantitative researches and in the field of health science findings presented in the study are of a more subjective nature, because there is a lack of support of findings with regard to the relative studies in this field. Though research question rose by the researchers, i.e. a correlation between clinical features and MRI findings improves that this issue should be considered for further development of surgical operations. Works cited 1. Borsboom, & Mellenbergh. (2004). The concept of validity. Psychological American Psychological Association, 111(4), 1061-1071. 2. Dootson, S. (1995). An in-depth study of triangulation. Journal of Advanced Nursing, 22, 183-187. 3. Grinnell, R. M. & Unrau, Y. A. (Eds.). (2005). Social Work Research and Evaluation: Quantitative and Qualitative Approaches (7th ed.). New York: Oxford University Press. 4. HLT505 Research Methods in Health Science. Study Guide. 5. Janardhana, A.P., Sharath Rao, R., & Kamath, A., (2010). Correlation between clinical features and magnetic resonance imaging findings in lumbar disc prolapse. Indian Journal of Orthopaedics, 44(3), 263-269.  6. Moore, J. (2008). A Critical Appraisal of Contemporary Approaches in the Quantitative Analysis of Behavior. The Psychological Record, 58(4), 641+. 7. Munro, B. H. (2001). Statistical methods for health care research (4th ed., pp. 223-243, 245-269). Philadelphia: Lippincott. 8. Newman, I., & Benz, C. R. (1998). Qualitative-Quantitative Research Methodology: Exploring the Interactive Continuum. Carbondale, IL: Southern Illinois University Press. 9. Patterson, M. E. (2000). Philosophy of Science and Leisure Research. Journal of Leisure Research, 32(1), 106. 10. Scanlan, C. L. (1986), Philosophical considerations in health professions. Health Sciences, 6: 54–63. 11. Sim, J., & Wright, C. (2000). Validity, reliability and allied concepts. In Research in health care: Concepts, designs and methods (pp. 123-139). Cheltenham, UK: Stanley Thornes Ltd. Read More