Chapter 8

Fundamentals of Respiratory
Care Research
 Learning Objectives (1 of 2)
 Explain why research activities are important
in healthcare.
 Describe several sources of information that
are commonly used during a literature
search.
 Review the various roles of those involved in
conducting research
 Argue the importance of evidence-based
medicine and note its limitations

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 Learning Objectives (2 of 2)
 Compare and contrast the types of research
design
 Describe strategies for getting started in
research
 Describe and give examples of how to
develop a study idea and write a research
protocol.
 Describe the three basic formats for
publishing a research study.

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 Overview of Respiratory Care
Research
 Research
 A scientific and systematic exploration of new
knowledge
 Scholarship
 Sharing the methods and findings of existing
research and knowledge through presentations at
professional events, as well as publishing
textbooks and journal articles

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 The Importance of Research
in Health Care
 Academic medicine has three basic missions:
 To heal
 To teach
 To discover
 Several stakeholders involved:
 Clinicians (who need the ability to assess the usefulness of
new equipment and treatments)
 Educators (who need the ability to find, summarize, and
present evidence for clinical activities)
 Administrators (who need to evaluate the quality of services
and the validity of policies/procedures)
 Researchers (who need to be able to generate new ideas
that inform the other stakeholders)
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 How to Review the Literature
(1 of 4)
 Bibliographic databases
 Contain books, book chapters, reports, citations, abstracts,
and either the full text of the articles indexed or links to the
full text
 Most popular is PubMed
 A service of the U.S. National Library of Medicine that
includes over 18 million citations from MEDLINE and other
life science journals for biomedical articles back to 1948
 Provides search filters, automatic e-mailing of search
updates, the ability to save records, and filters for search
results using "My NCBI”

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 How to Review the Literature
(2 of 4)
Synthesized databases
 Prefiltered records for particular topics

 Usually subscription based with relatively

large fees
 May provide the “best” evidence without

extensive searches of standard bibliographic

databases
 The leading database in this category is the

Cochrane Collaboration

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 How to Review the Literature
(3 of 4)
 Portals
 Web pages that act as a starting point for using
the Web or web-based services
 Examples:
 ClinicalKey
• Provides links to books, journals, Clinics in Medicine,
patient education resources, and images
 Ovid
• Provides links to books, journals, evidence-based
medicine databases, and the Cumulative Index to
Nursing and Allied Health Literature (CINAHL)

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 How to Review the Literature
(4 of 4)
Electronic journals and books
 We are rapidly reaching the point where all medical

journals are available only online

 Respiratory Care journal

 Electronic versions of textbooks available on the

Internet
 Subscription services are also available

General Internet resources

 General search engine

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 Suggestions for Conducting
Searches
 Talk to a professional librarian!
 Use bibliographic software such as:
 EndNote
 RefWorks
 Zotero
 Mendeley

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 Evaluating the Quality
of Research (1 of 2)
 Peer reviewed
 Evidence-based medicine (EBM)
 A rigorous and systematic review of available
evidence
 A critical analysis of available evidence to
determine which conclusions are most sound and
applicable
 A disciplined approach to incorporating the
literature with personal practice and experience

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 Evaluating the Quality
of Research (2 of 2)
 Case report
 The simplest and least rigorous design is a single
case report, in which a new clinical issue or
problem is described in a single patient
 Cohort studies
 Compare the clinical outcomes of two groups
 Generally have greater scientific rigor than case
studies or case series

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 Cohort Studies
 Observational cohort study
 Compares the outcomes between two groups of
patients, with the treatment allocated to one group
but not the other
 Key idea is that the groups are selected by an
intervention of the investigator
 Randomized controlled trial (RCT)
 Mitigates confounding factors by randomly
assigning study participants into either a treatment
group
 Usually considered the strongest study design
because it has the least risk of bias
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 Research Design
 The major purpose of a research design
 Control of potential nuisance variables
 Four methods of control
 Random selection
 Matching of subjects between groups or grouping
of subjects based on a nuisance variable to
achieve homogeneity
 Including a nuisance variable as a treatment
variable
 Statistical removal of a nuisance variable through
analysis of co-variance.

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 Experimental Design
 Pre-experimental
 There is little or no control of extraneous nuisance
variables
 Useful for a pilot study
 Quasi-experimental
 Designs lack full control of all variables, but there
is an effort to compensate with other controls.
 True experimental
 Designs provide full control of variables by one or
more of the methods previously described

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 Types of RCTs
 Parallel-control study
 Compare two groups: one receives the treatment
being studied, and the other receives the control
treatment
 Crossover study
 The study treatment is first administered to one
group of study subjects while the other group
receives the control or comparison treatment
 After measuring outcomes and a subsequent
“washout period”, the group initially given the
study treatment receives the control treatment and
the group initially given the control treatment
receives the study treatment
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 How to Begin Doing Research
 How to develop a study idea
 Formulate a problem statement
 Generate a hypothesis
 Define rejection criteria
 Make a prediction
 Perform the experiment
 Test the hypothesis

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 Key Roles in Research
 Principal investigator
 The one who is ultimately responsible for
completing the study in compliance with all
applicable rules and regulations and for adhering
to the protocol approved by the IRB
 Co-investigators
 Consultants
 Study subjects

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 How to Write the Abstract

 A condensed version of a research paper that

appears at the beginning of the publication
 Most journals restrict the length of the
abstract
 Should include an introduction, background,
study purpose, methods, results, discussion
 Start with a longer abstract and then edit
 The idea is to decrease word count while
increasing clarity

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 How to Make a Poster
 A poster allows a bit more freedom in terms of
space as compared to an abstract
 Generally 4 feet tall by 6 feet long
 Make sure the graphics are at least 300 dots
per inch (dpi)
 Posters are usually presented in a group of
maybe 10-15 in small rooms
 The posters are hung on stands and visitors
walk around reading them and discussing
them with the authors
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 How to Write a Paper (1 of 2)
 Takes anywhere from 20 to 100 hours
 Has the same basic outline as an abstract or
poster but goes into much greater detail
 Has a references section
 No word limit for the Introduction (within
reason)
 Most journals have a maximum word count
for the full text of the paper (usually in the
range of 2000-3000 words, depending on the
journal)
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 How to Write a Paper (2 of 2)
 Introduction
 Provide a brief background explaining why the study was conducted and
why it is of interest
 Research problem or hypothesis should be included
 Methods
 Explains to the reader exactly what was done to answer the research
question and/or test the hypotheses described in the Introduction
 Results
 Presents the data gathered from the experiments
 Discussion
 Show how the results answered the research question that was first
described in the Introduction
 Should interpret the results in the face of earlier studies’ conclusions
 Conclusion
 Conclusions made should be briefly explained, including reasons for
rejecting alternate interpretations

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 How to Respond to Reviewers
 Usually reviewed by two or three “peer reviewers”
 Reviewers will read and critique any and everything
about your paper, from what words you use, to what
measurements you made, to what statistical
procedures you used
 Recommend to the journal editor one of three
outcomes
 That your paper should not be considered for publication
 Rejected with an opportunity to revise and resubmit
 That the paper should be accepted as is

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