High-quality Research Designs Research Articles

P.6.013 Polysubstance use among HIV-infected drinkers in Russia

During puberty, when young people are completing their education, transitioning into employment, and forming longer-term intimate relationships, a shift in emotional regulation and an increase in risky behaviour, including substance use, is seen. This Series paper considers the potential effects of alcohol, tobacco, and illicit drug use during this period on: social, psychological, and health outcomes in adolescence and young adulthood; role transitions, and later health and social outcomes of regular substance use initiated in adolescence; and the offspring of young people who use substances. We sourced consistent support for causal relations between substance use and outcomes and evidence of biological plausibility from different but complementary research designs. Many adverse health and social outcomes have been associated with different types of substance use. The major challenge lies in deciding which are causal. Furthermore, qualitatively different harms are associated with different substances, differences in life stage when these harms occur, and the quality of evidence for different substances and health outcomes varies substantially. The preponderance of evidence comes from a few high-income countries, thus whether the same social and health outcomes would occur in other countries and cultures is unclear. Nonetheless, the number of harms that are causally related to substance use in young people warrant high-quality research design interventions to prevent or ameliorate these harms.

An Undergraduate Course to Bridge the Gap between Textbooks and Scientific Research

This article reports on a one-semester Advanced Cell Biology course that endeavors to bridge the gap between gaining basic textbook knowledge about cell biology and learning to think and work as a researcher. The key elements of this course are 1) learning to work with primary articles in order to get acquainted with the field of choice, to learn scientific reasoning, and to identify gaps in our current knowledge that represent opportunities for further research; 2) formulating a research project with fellow students; 3) gaining thorough knowledge of relevant methodology and technologies used within the field of cell biology; 4) developing cooperation and leadership skills; and 5) presenting and defending research projects before a jury of experts. The course activities were student centered and focused on designing a genuine research program. Our 5-yr experience with this course demonstrates that 1) undergraduate students are capable of delivering high-quality research designs that meet professional standards, and 2) the authenticity of the learning environment in this course strongly engages students to become self-directed and critical thinkers. We hope to provide colleagues with an example of a course that encourages and stimulates students to develop essential research thinking skills.

Advances in Exercise, Fitness, and Performance Genomics

An annual review publication of the most significant articles in exercise, fitness, and performance genomics begins with this article, which covers 2 yr, 2008 and 2009. The review emphasizes the strongest articles as defined by sample size, quality of phenotype measurements, quality of the exercise program or physical activity exposure, study design, adjustment for multiple testing, quality of genotyping, and other related study characteristics. With this avowed focus on the highest quality articles, only a small number of published articles are reviewed. Among the most significant findings reported here are a brief overview of the first genome-wide association study of the genetic differences between exercisers and nonexercisers. In addition, the latest results on the actinin alpha 3 (ACTN3) R577X nonsense polymorphism are reviewed, emphasizing that no definitive conclusion can be reached at this time. Recent studies that have dealt with mitochondrial DNA haplogroups and endurance performance are described. Published reports indicating that physical activity may attenuate the effect of the fat mass and obesity associated (FTO) gene risk allele on body mass index are reviewed. Articles that have tested the contributions of specific genes to the response of glucose and insulin metabolism traits to regular exercise or physical activity level are considered and found to be generally inconclusive at this stage. Studies examining ethnic differences in the response of blood lipids and lipoproteins to exercise training cannot unequivocally relate these to apolipoprotein E (APOE) genotypes. Hemodynamic changes with exercise training were reported to be associated to sequence variation in kinesin heavy chain (KIF5B), but no replication study is available as of yet. We conclude from this first installment that exercise scientists need to prioritize high-quality research designs and that replication studies with large sample sizes are urgently needed.

Outcomes in Microsurgery

The reporting of microsurgical outcomes has been variable. Historically, emphasis has been placed on flap and digit survival or failure in the case of free-tissue transfer or digit replantation, respectively. Outcomes have also been measured with indices such as range of motion or grip strength for digital replantations, the ability to eat or talk for head and neck microsurgery, and the ability to walk or return to work for lower extremity microsurgery. Although relevant, this type of reporting of outcomes may fail to capture the effectiveness of microsurgical intervention from the patient's, the third-party payer's, or society's perspective. Significant events have arisen in the past two decades, including the emphasis on outcomes research, recent recommendations to adopt evidence-based microsurgery, and the inclusion in academic training programs of the competency "manager" to the health care system. This necessitates rethinking the way we report outcomes in microsurgery. This article explains the need to (1) use health-related quality-of-life scales to measure the benefits of microsurgical interventions, (2) measure outcomes with high-quality clinical research designs, and (3) incorporate proper cost-effectiveness studies in our clinical research before adopting new technologies such as new free flaps or techniques.

Understanding high quality research designs for speech language pathology

As innovative methods, strategies, or curriculum are introduced to assist clients with speech and language disorders, many Speech-Language Pathologists (SLPs) may question the effectiveness of the intervention and more specifically whether the results that they are seeing are the result of the intervention (i.e., cause/effect). Several research designs allow researchers to examine causality including the most widely known, the randomized controlled trial (RCT). While not all situations are suited to applying the RCT, other high quality designs may be used that still lend evidence of causality even when randomization is not possible. The purpose of this paper is to provide a brief summary and illustrations of randomized controlled trials (RCT) and quasi-experimental design (QED) that are appropriate for the study of treatment effectiveness in speech-language pathology research, present potential barriers to quality randomization, and provide guidelines to help identify RCTs.

Evidence for the effectiveness of botulinum toxin for spasmodic dysphonia from high-quality research designs

The practice of evidence-based medicine promotes use of the knowledge ascertained from high quality research designs. The objective of this review was to determine what evidence has been provided from high quality research designs (e.g., randomized control trials or high quality prospective, matched group cohort studies), through December of 2006, relative to the effectiveness of botulinum toxin for treating spasmodic dysphonia. Results of the review indicated that no new high quality (Class I or Class II) studies have been published since 2001. One Class I study has been published since 1973, which found significant treatment effects for acoustic and perceptual variables of vocal function. Four Class II studies have been published during this same time frame, all finding significant treatment effects, though the nature of studied factors was variable between investigations. Based on the quality of evidence scale used, botulinum toxin can be considered an effective treatment for adductor spasmodic dysphonia.

Evidenzbasierung gemeindepsychiatrischer Versorgungsangebote in Deutschland: eine Bestandsaufnahme

One of the outcomes of reforming mental health care in Germany has been the establishment of a range of community mental health services. However, current evidence for the effectiveness of these services is slight. Based on a literature search this article provides a systematic overview of empirical research in this sphere. In detail, social psychiatric services, crisis centres, psychosocial contact points, day care centres, and various models of supported housing and work/employment are assessed. Available results on effectiveness are classified according to their level of scientific evidence. The current state of research is characterised by the situation that effectiveness of the care approach provided by social psychiatric services and some types of supported housing and work/employment has been demonstrated at a medium level of scientific evidence. In contrast, the evidence level of mental health care provided in crisis centres, psychosocial contact points, and day care centres is poor. The major reasons for this lack of research are: heterogeneity of care models and staffing levels in the different community mental health services, lack of standardised documentation and reporting system in these services, and lack of research culture to utilise routine outcome data. The consequences of aiming at increasing the level of scientific evidence in this sphere would be to intensify funding of research projects and to implement high quality research designs such as randomised controlled trials.

Monetary Costs and Benefits of Crime Prevention Programs

Few attempts have been made to calculate the monetary costs and benefits of crime prevention programs. Existing calculations for situational, developmental, and community prevention, and correctional intervention programs give hopeful indications that benefits often exceed costs. However, the noncomparability of methods used in different studies makes it impossible to determine which program or class of programs is the most economically efficient. A "how-to" manual should be developed and followed. A wide range of benefits should be measured, including health, employment, and education benefits, as well as crime reduction. Research is needed on issues such as using average versus marginal costs, using capital versus operating costs, discounting costs and benefits over different time periods, using tangible versus intangible victim costs, and calculating costs and benefits from different perspectives (such as victim, taxpayer, or program participant). Because the value of an economic analysis is limited by the quality of the research design, greater use should be made of high quality research designs combined with benefit-cost analyses. Funding agencies should commission and support benefit-cost evaluations of new and existing prevention programs.