¬¬¬¬¬ I've written this description of research in answer to the oft repeated statement of friends and family that they do not know what research really is. In healthcare forums, some reveal their lack of awareness regarding research's place in science and in healthcare by the nature of their comments. Sharing this description also emphasizes the standard which I strive to match or exceed in my written discussions. Rationality and objectivity are valuable tools, especially when the well being of others is relying on conscious leadership. Though research/science is imperfect being of the physical world; we nevertheless must make some standard by which to provide the highest possible action in the given moment. ¬¬¬¬¬ by Janet Still MSN FNP
Research is a diligent, controlled study that validates and refines existing knowledge and develops new knowledge. The ultimate goal of research is the development of an empirical body of knowledge for a discipline or profession. Research is essential to develop and refine knowledge that can be used to improve clinical methods of care, for example. What some simply call "science" is the practice of this type of detailed and recorded observation, which is then analysed and compared to many (hopefully) other studies to draw a yet newer overall picture of the studied method/practice.
Critical thinking, developed and practiced, is essential to analysis of research results. So, setting up a formal study of a treatment or methodology for giving care for specific illness must consider carefully how to prevent "noise" in the observations as well as in the reading and the application of results. Many procedures have been created for insuring unaffected and non-biased studies. These various procedures are the result of continued analysis too. Critical thinking, then, refers to a process of ordering thought such that reasoning is reliable and inarguable.
The professional that provides specialize care must have the ability to provide exceptional physical assessments as well as good critical thinking to assist patients in serious and unstable conditions to reach their maximum health. You might say that goes without question...yet perhaps one should question this very situation! There are as many angles to scrutinizing your healthcare situation as there are words in this sentence (entirely too many haha). I have written on this topic in a number of philosophical articles in this blog. But practically speaking, what matters is what works; and I, like other healthcare providers and experts, have come to recognize that the patient at the center of decision-making is key to effective treatment.
Communication is integral in healthcare on levels too many to attempt enumerating in this article. Understanding the basis of treatment....research studies ...at least a basic understanding, is you-the-patient's tool for assessing the validity of a treatment choice. As always, at the bottom of this article, I will include some resources for you to have in hand for those treatment discussion clinic appointments.
Despite the suppressed groan of healthcare workers and providers on seeing the patient arrive, armed with education of all things! you-the-patient are the primary decision-maker regarding your care, whether you abdicate your power or not. So their reaction expresses either their lack of understanding or their poor communication skills in previous encounters with educated patients. Let me insert here, especially for healthcare providers scanning this, that you-the-patient are not the expert on the latest research just because you found some articles. You are the expert on You, on what works for your balance in your life, on interpreting an illness' priority in your life, and on what amount of surrender you are willing to experience in a health crisis. The healthcare providers are your tools - to interpret pertinent research, to explain options in care, to find you the best specialists available at your behest, and/or to provide you the treatment that you both agree is most suitable given your unique circumstances. (See the References below for current thought on patient-centered healthcare).
One last example to flesh out the reasoning behind understanding research.... statistics. Ugh, one might comment, meaningless numbers. And I agree the numbers out of context are quite meaningless. Recently, my partner in a documentary presentation of chronic pain asked me why the total numbers given of the condition have such a wide disparity. He could not understand how to present such a spread when speaking of the occurrence of the condition. There are key pieces to creating a research study. One piece is what is called the sample. The sample is how large (or small) the number of subjects in the study. The media is fond of headlining big or small numbers for capturing your attention. But the number is meaningless unless you know how many people were actually studied. In other words, stating that 80% of subjects studied improved with a drug is not so sensational when you read further and learn only ten people were used in the study. Another study with a much larger sample of the population might (probably would) have a much smaller percentage result. There is even more to this number thing....how were the subjects decided upon? what age group? what gender? what region of residence? on and on.... so many conditions that can affect the outcome.
Another piece that causes seemingly wide gaps in given results of formal studies is when was the study performed? Was the study you are reviewing for a particular nation? or global? What exactly is the study attempting to define? and what you are looking for? Like any internet search, the keywords determine the results. So before you begin to look for answers, define your question as concisely as you can in order to actually obtain some good leads. If you are coming up with widely diverse answers, why? Maybe this is a question for your provider as well. Yet, you may not be paying attention to details like how old the information is (look at dates on your links!), what aspect of the condition the research was designed to study (cause, symptomology, treatment, epidemiology), do you have the correct title of your condition (diabetes one or two give very different results).
To encapsulate the point of this brief essay: research is meant to establish the most reliable observations of the current day on particular conditions or organisms. Of course research is of multiple disciplines, astronomy, biology, mathematics and physics, genetics, environmental mechanisms, and more. And research is an ongoing, ever dynamic study analysis of the discipline or of the condition....so there can be and ARE changes in the accepted thought and practice, based on research. In this essay, I attempt to provide another way of perceiving research that directly impacts You. My viewpoint is take all research "results" with a grain of salt as my grandparents used to say. And look further, deeper. Who funded the study? Did anyone building the study's design have reason to desire one outcome over another? Were the methods used of the highest standard today? and how do you know that? But finally, as always, get some varied expert opinions on the study results. And do not take the first opinion out of the gate! This is your life. Make it interesting....by taking part in the decision-making.
A quirky but informative (and short) video explaining the very basics of research by Greg Martin with Global Health: https://youtu.be/PDjS20kic54 This is the first of several he produced to elucidate what is research and research methods. Essentially, he puts research in context in the world.
For a really fun learning experience the Khan Academy has raised the bar. A father wanting to help his son with mathematics has turned into a hugely popular online interactive virtual lesson platform. Keeping on topic with healthcare, I am providing you the link to the Biology school: https://www.khanacademy.org/science/biology Know that Khan Academy is known for its comfortable, friendly and fun demeanor making all "lessons" easy as a game.
In the interest of possible avenues to figure out what the heck my doc is talking about to cute questions my kids ask to well what is this symptom about anyway, Its The Small Things offers some readable info on things we cannot see but sure can feel! https://heathermicrobiologyjackson.wordpress.com/tag/immunology-2/page/2/
On a more serious note, how about a reliable source for research studies more likely to be reliably performed? The Cochrane Library is widely accepted as a reliable peer reviewed source to locate many many MANY research studies. This video helps you learn how to find it and how to use it: https://youtu.be/Iv-cI03UMP8
De Silva, D. (2011). Evidence: Helping people help themselves; from The Health Foundation; 52. Retrieved from: http://www.health.org.uk/public/cms/75/76/313/2434/Helping%20people%20help%20themselves%20publication.pdf?realName=03JXkw.pdf
Epstein, R., Fiscella, K., Lesser, C., & Stange, K. (2010). Why the nation needs a policy push on patient-centered health care; Health Affairs 29(8); 1-7.
Institute for Patient and Family Centered Care (2014). Useful links. Retrieved from: http://www.ipfcc.org/tools/links.html