Scientific Research in Health: Methods, Types, and Priorities
Introduction to Scientific Research in Health
Etymology: The term “research” originates from the Latin in (on) and vestigare (find, inquire, investigate, follow traces), meaning to find or describe something. In science, research is a systematic, controlled, and critical process to discover or interpret facts, phenomena, relationships, or laws.
Research Activity: Develops or contributes to generalizable knowledge, encompassing theories, principles, information, and data collection.
Theoretical Foundations
Scientific Knowledge: Overview and basic concepts.
Conocer (Knowing): An intellectual process establishing a relationship between the knower (actor) and the known object (reality). Knowledge is acquired through recognizing an existing reality with certain features.
Knowledge Derivation:
- Empiricism: Knowledge from random experience, without a personal research method.
- Science: Observation, description, explanation, and prediction using logical methods.
Types of Health Research
Basic, clinical, epidemiological, and social science research.
Why Health Research?
- To study relevant health problems and produce transferable clinical results.
- To optimize health resource use, ensuring sustainability and equity in healthcare.
- To serve healthy individuals and those with risk factors, extending beyond traditional clinical research.
Classification of Research
Research is classified by:
- Application of Results: Applied, Basic, Basic-oriented, and Development work.
- State of Knowledge: Exploratory, Descriptive, Explanatory, and Correlational.
Types of Investigations by Application
- Applied Research: Addresses practical problems with direct, applicable solutions.
- Basic Research: Seeks new knowledge without immediate practical application.
- Basic-Oriented Research: Connects indirectly to practice, with potential future applications.
- Development Work: Focuses on creating and refining new materials, products, or procedures.
Types of Investigations by Knowledge State
- Exploratory Studies: Clarify and define problems in little-known areas.
- Descriptive Studies: Build on exploratory studies to detail characteristics and relationships.
- Explanatory Studies: Investigate cause-effect relationships through experimental (clinical trials) or analytical observational (cohort, case-control) methods.
- Correlational Studies: Measure the degree of relationship between variables.
Types of Research by Potential Application
Applied, Basic, Basic-oriented, Development work.
Types of Research by Knowledge Status
Exploratory, descriptive, explanatory, correlational.
I. Experimental Studies
Researchers control the variable of interest and randomly assign subjects.
a) Laboratory Tests:
Controlled environment, manipulation of variables, often using animals or human cells/tissues. Example: drug dosage and side effect evaluation in animal models before human trials.
b) Controlled Clinical Trials:
Evaluate treatments or preventive measures in patients with a disease, using random assignment and blinding where possible.
c) Field Studies:
Preventive interventions in disease-free subjects, requiring large sample sizes and random assignment. Example: vitamin C for cold prevention, hepatitis B vaccine efficacy.
d) Randomized Study Groups (Clusters):
Community-based interventions, randomly assigning clusters of individuals. Example: evaluating educational programs on burns or drug use prevention.
Community Test:
Pilot studies evaluating interventions’ impact on community health.
II. Quasi-Experimental Studies
Non-random assignment of interventions. Example: fluoride supplementation in one community versus another.
III. Observational Studies
No variable manipulation, observing naturally occurring events.
a) Cross-Sectional Studies:
Prevalence studies, assessing exposure and disease simultaneously. Example: malnutrition prevalence in hospitalized children.
b) Case-Control Studies:
Comparing past exposures between individuals with (cases) and without (controls) a disease. Example: factors associated with intrauterine growth restriction.
c) Cohort Studies:
Following disease-free subjects based on exposure status, observing disease incidence over time. Example: leukemia incidence after Hiroshima bombing.
d) Screening Studies:
Identifying diseases in apparently healthy individuals using tests. Example: newborn screening for metabolic disorders, HIV testing in at-risk children.
e) Case Studies:
Describing clinical features of rare or unusual conditions. Example: congenital lobar emphysema case report.
f) Ecological Studies:
Analyzing population-level data. Example: pneumococcal mortality by region.
g) Hybrid Studies:
Combining multiple study types. Example: case-control analysis within a cohort study.
Research Design Classifications
I. Directionality
a) Prospective:
Data collected after study initiation.
b) Retrospective:
Data collected before study initiation.
c) Bi-directional:
Combination of prospective and retrospective data collection.
II. Measurement Occasions
a) Transversal:
Single measurement.
b) Longitudinal:
Multiple measurements over time.
III. Number of Samples
a) Descriptive:
Single population or sample.
b) Comparative:
Two or more populations or samples.
Priorities in Health Research
Evidence-Based Medicine, Quality of Care, Organizational Models and Service Delivery, Integration of Health Care, Prescriptions and Economic Analysis, Communication, Inequalities, and Health Promotion.
Focus of Research at Local Level
- Health education
- Environmental health
- Health services
- Nutritional status of the population
- Appropriate technologies and traditional medicine
- Perception of health disease
- Quality of care and satisfaction of people